Management of haemorroids with endoscopic band ligation

To assess results of rubber band ligation in the management of hemorrhoids especially in patients with liver cirrhosis and portal hypertension; and incomplete mucosal prolapse. This study was conducted on 109 patients who were presented to the out-patient clinic and Endoscopy Unit of Kafer El-Shiekh Liver Researches Center; Outpatient Health Insurance Clinics in Kafer El-SheiKh, Damiaua and Mansourah; and Al-Azher university hospital [New Damiatta] in the period between January 2005 to June 2007. All patients were treated by the same group of surgeon. Successful results without complications were achieved in 96 cases [88.1%] in 18-months mean follow-up [range 8 to 24 months]. A total of 13 patients [11.9%] had complications which required no hospitalization. Pain in 5 cases [4.5%], rectal tenesmus in 3 cases [2.8%], and transient anal bleeding in 3 cases [2.8%], two cases of dysuria [1.8%]; were the most frequent complications. By using this safe and convenient treatment we can save hundreds of hospitalization days and thousands of sick-leave days per year. We conclude that this is a very simple technique, allowing excellent results with few complications. Also, RBL seems to be safe in patients with liver cirrhosis and portal hypertension

Comparative retrospective study of bleeding esophageal varices management chronic injection sclerotherapy versus splenectomy and devascularization

This study was conducted to evaluate and compare between chronic Injection sclerotherapy in 63 patients and splenectomy and devascularization in 37 patients in the management of bleeding esophageal varices in Egyptian patients suffering from schistosomiasis hepatosplenic fibrosis. It was found that the most common grade that causes bleeding varices was grade III. The study reported complete disappearance and obliteration of varices in 63 patients via 180 sessions of injection sclerotherapy. A rate of 6.3% of rebleeding attacks in those patients was also reported. While, a rebleeding rate of 10.8% in the second group of splenectomy and devascularization was reported. The study also reported two deaths in the sclerotherapy group from 63 patients and no deaths in the second operative group [37 patients]; so, the total mortality rate was 2% only from 100 patients

Comparative study of minimal invasive cholecystectomy versus laparoscopic cholecystectomy

A total of 133 patients complaining of gallbladder disease was operated upon; 75 patients for minimal invasive cholecystectomy [MIC] [incision 5 cm] and 58 patients for laparoscopic cholecystectomy [LC]. The study relied on US examination. The severity of GB disease, requirements of analgesia, hospital stay, conversion and complication rates were compared in both groups. It was found that MIC was comparable with LC in terms of postoperative analgesia and significantly less operative time. MIC could be easily performed in the developing countries where facilities for LC may not be available. Although, LC has a simple postoperative course and has the advantage of full abdominal exploration, there are still other contraindications to it as the absolute refusal of the patient, hemorrhagic syndrome or massive cirrhosis and fistula between the liver and gut. MIC is preferred as it represents a safe, inexpensive method for treating non-complicated gallstones, especially in the developing countries

Stapling techniques in colorectal cancer surgery

This prospective non-randomized study was performed on 65 patients with carcinoma of the colorectal region undergoing a stapler anastomoses using the ILS stapler system. The overall incidence of complications was 36.9% [15.3% general complications and 21.6% related complications]. The possibly related general complications were seven cases of wound infections and one case of wound dehiscence. While, the unrelated general complications [3%] were one case of hematemesis and another one as pulmonary embolus. As regards the related complications, five cases of leakage, five cases of stricture and four cases of local recurrence were reported. The duration of surgery varied from 90 to 190 minutes with a mean time of 125 minutes; while, time consumed to create and complete anastomosis varied from 10 to 20 minutes with a mean time of 14 minutes. Sphincter functions were not affected via endoscopic and manometric examination. The stapled anastomosis was ten times expensive [EP 600] than other ordinary techniques [EP 60]. Hospital stay after surgery ranged from 10 to 27 days with a mean stay of 14.9 days. There was no mortality