Clinical oncology research; Review on contemporary methodology standards.

Evaluation of novel treatments through clinical trials remains the backbone of oncological clinical research, but only a minor portion have been tested in Phase III trials. The continued publication of underpowered trials provides an ongoing need for meta-analyses to detect clinically significant outcomes. Although tumor relapse and survival are important issues and easily measured outcomes in trials, they are often not the most relevant indicators for treatment success. As diagnostic technologies and treatments continue to advance, methodologies defining high quality studies have been established, but still enthusiasm to adopt novel technologies that leads to studies holding well-described bias that do not aid the rational use of the studied test. Global awareness of such bias and standard research methodology is the clue toward iconic studies giving rational supporting novel cancer treatments and patients' support.

An Innovative Emergency Laparoscopic Cholecystectomy Technique; Early Results Towards Complication Free Surgery.

BACKGROUND: The performance of laparoscopic cholecystectomy could be a technical challenge. Procedure success depends on multiple factors namely: hepatobiliary anatomical variations, pathologic changes in the gallbladder and surrounding tissues, pre-operative interventional attempts, the individual surgeon's skill and finally patient co-morbidities. Anticipating the attendant challenges, can help to avoid several known complications associated with this procedure. Searching a more reliable anatomical topography to adopt during laparoscopic cholecystectomy is the basis for a safe surgical technique. METHODS: Between January 2012 and August 2015, 525 cases were presented with acute cholecystitis. Patients were classified in to two groups regarding degree of dissection difficulty. The study concept is defined and applied by the author in all study cases. No single case was excluded from the study. RESULTS: Results are processed in comparative way between both groups of the study. The increased risk results in Group B are related to technical difficulties. CONCLUSION: The study has offered a novel anatomical concept and safe surgical technique avoiding exploration of Calot's triangle. The new concept has minimized dissection demands and risk of injury related to the traditional laparoscopic cholecystectomy. The study has proposed a potentially secure and empirical laparoscopic cholecystectomy technique that could be considered in every case.

Early results of dual approach hernioplasty (DAH): an innovative laparoscopic inguinal hernioplasty technique.

BACKGROUND: In this study, the proposed technique is combining the invented method of extraperitoneal dissection utilizing gas insufflation through Veress needle introduced from the groin with the transabdominal approach. Such a combination minimizes operative demands, achieves major goals, and reduce operative time in an attempt to improve laparoscopic hernioplasty techniques. METHODS: The study recruited 211 patients having primary reducible inguinal hernia upon first diagnosis. Abdominal ultrasound examination achieved to exclude any additional pathology and confirming clinical diagnosis. The new technique is applied on all patients without any modification through the whole series. RESULTS: Patients' epidemiology, operative characteristics, and follow-up are all tabulated. Results showed no complications nor conversion to open procedure. CONCLUSIONS: The proposed procedure showed preliminary encouraging results regarding technique, clinical outcome, time-saving, and patients' safety. Combination of extraperitoneal gas-derived dissection, transabdominal field review, and preperitoneal mesh application offers an innovative and promising laparoscopic hernioplasty technique. The study is introducing the technique and as well invites further trials on wider scale to verify the technique.

Bilateral external carotid artery ligation: A life saving procedure in severe maxillofacial trauma.

INTRODUCTION: Bilateral external carotid arteries ligation is a rare practice in cases of extensive maxilla-facial injuries. Defining indication criteria in the management of such cases is highly demanded in emergency surgery. CASE PRESENTATION: Reported case presents a male patient 67 years old man with a gunshot to the face. The whole face was macerated. Patient was operated surgically performing bilateral external carotid artery ligation, tracheostomy, pharyngostomy, gastrostomy and pressure dressing to face and head. CONCLUSION: The procedure of bilateral external carotid artery ligation has no defined role in the management of maxillofacial trauma. The current status of such procedure in maxillofacial trauma needs revision.