Local recurrence after radical cystectomy

Ninety patients underwent radical cystectomy and urinary diversion for carcinoma of the urinary bladder, eleven patient [12.2%] died postoperatively from different surgical and non-surgical causes Seventy nine were followed up regularly. The follow up includes physical examination and appropriate laboratory and radiological investigation. The duration of follow up ranged from two year, to 3 years, late mortality occurred in 23 patients [29.1%] for reasons other than local recurrence. Local recurrence was discovered in 21 patients [26.6%]. The majority of recurrences [90.4%] were discovered during the first year of follow up and the pelvic areolar tissue represents the main site of local recurrence [81%]

Surgical treatment of upper limb hyperhidrosis

15 patients with severe disabling hyperhidrosis of the upper limb were subjected to operation. 20 sympathectomies were performed for palmer hyperhidrosis through supra-clavicular approach. In 19 sympathectomies the patients were completely satisfied with the results of their operation. Transient Hormer's syndrome occurred in two patients and this had completely resolved in two weaks. 12 patients with axillary Hyperhidrosis submitted to local excision of axillary sweat glands, 11 patients were pleased with outcome of their surgery. These results are encouraging and we recommended supraclavicular sympathectomy for palmar hyperhidrosis and local excision of axillary sweat glands for axillary hyper hidrosis

Transhiatal esophagectomy preliminary report

In this study, we report on 7 cases underwent transhiatal esophagectomy in El Hussien University Hospital [5 cases of benign stricture and 2 cases of carcinoma of esophagus] followed by gastric interposition. The bleeding was nil, no thoracotomy was needed and no anastomotic leak occurs. The technique was easy and with no major post-operative complications

Evaluation of computed tomography and ultrasonography in detection and staging of malignant abdominal disease

Twenty-six patients of malignant abdominal disease in EI-Hussein University Hospital were studied pre-operatively by computed tomography and ultrasonography. The results were compared with the operative findings to detect the accuracy of computed tomography and ultrasonography in staging of malignant abdominal disease. C.T. proved to be of high accuracy rate in pre-operative staging and, evaluation of malignant abdominal disease which helped much in the pre-operative decision making. The accuracy rate of C.T. in detection of liver metastases was 84%, while its accuracy in detection of adjacent organ infilteration was 94%. Its accuracy in detection of para-aortic LN. enlargement was 90% while its accuracy in detection of adjacent LN. enlargement was found to be 75%. Its accuracy in detection of ascitis was 88%. The accuracy rate of ultra-sonography in detection of liver metastases was 75%. Its accuracy in detection of ascitis was found to be 75%

Pathological study of clinically diagnosed benign breast masses

120 female patients presented to Al Azhar University Hospital with a lump in the breast which was diagnosed as a benign mass on clinical examination. All masses were sent for histopathological examination, the incidence of malignancy in the clinically diagnosed benign masses was 12.5%. Fibroadenomas were the commonest masses encountered in the study and forms 47.5%, fibrocystic disease was the second infrequency and from 30% of the cases. Malignant lesions were the third infrequency and form 12.5% of cases followed by non specific mastitis which forms 5% of cases, there was 2 cases of glactocele and 2 cases of duct ectasia, 2 cases cytsoarcompaphylloids. and one case of intraduct papilloma

Evaluation of aspiration biopsy cytology in the diagnosis of solitary thyroid nodule

Thirty nine patients [35 femals and 4 males] presenting with solitary non toxic thyroid nodule were admitted to El Hussein University Hospital on the period between September 89 to May 1991. They were subjected to full history and, clinical examination, serum T3 and T4 levels, ultrasonic and isotope scanning. Fine needle aspiration biopsy [Aspiration Biobsy Cytology, ABC] was done for every patient and the results obtained were compared with the results obtained by excisional biopsy. In our study the sensitivety for the presence of the tumour was 75% and when we added follicular adenoma as a positive for the tumour the sensitivity increased to become 86%. The specificity for the abscence of the tumour was 100% [there is no false positive cases] the false negative rate was 3.2% the positive predicitive value was 100%, the negative predictive value was 97%. The over all accuracy of ABC was 92.3%