Outcomes of Vacuum-Assisted Beast Biopsy for Management of Benign Breast Masses.

INTRODUCTION: The triple assessment, which combines a clinical examination, radiological imaging, and pathology, is used to assess the breast mass. The open excision of the suspicious lesion is the gold standard for breast biopsy techniques. However, because an excisional biopsy always results in a scar, many surgeons are considering less invasive, alternative methods due to the cost and morbidity of this operation. Image-guided percutaneous core-needle biopsy has recently gained popularity in identifying palpable and non-palpable breast lesions. Vacuum- assisted breast biopsy (VABB) was created to address some of these limitations of core-needle biopsy. METHODOLOGY: We performed a retrospective review of 38 patients who underwent VABB.To Report the recurrence one-year post-VABB for management of benign breast masses and To evaluate patient-reported cosmetic satisfaction using the cosmetic scale. RESULTS: The mean age of the study participants was about 30.34 (±10.11) years. The average size of breast masses was 1.23 (±0.83) cm. The recurrence rate was 13.16%, confirmed by follow up ultrasound and all these patients underwent excisional biopsy. There were significant differences in breast mass recurrence rate by the side affected. Recurrence was more likely in right-sided breast masses (P=0.048).In our study, no significant relationships between the occurrence of complications following surgery and patients 'demographics and mass features and no infection were reported. The hematoma was reported in 2 patients 5.26 %, Mild induration at the site of surgery 2 patients 5.26 %, Small contusion at the site of surgery in one patient 2.63 % and no other complication was reported. The patient's cosmetic satisfaction using the cosmetic scale from 1-5,1: not satisfied,2:low satisfaction,3:mild satisfaction,4:moderate satisfaction,5; completely satisfied, The mean cosmetic score was 4.03. CONCLUSION: Our study concluded that VABB is reliable for removing small benign breast masses with a satisfying cosmetic outcome &low recurrence rate, and fewer complications.

Mammary Myofibroblastoma in a Male: A Case Report and Review of the Literature.

Mammary myofibroblastoma is a rare benign tumor. It is mainly seen in older men and postmenopausal women. These tumors can be presented with a palpable mass or can be discovered incidentally on routine screening. A 76-year-old male presented with a palpable breast mass that was increasing in size. The patient underwent wide local excision with no postoperative complications. The pathology finding was consistent with myofibroblastoma. Myofibroblastoma is a rare tumor and should be considered one of the differential diagnoses in breast lumps.

Fistula between the rectal stump and left iliac artery.

BACKGROUND: Isolated iliac artery aneurysms are rare and difficult to diagnose. It is more common in males. It can be asymptomatic at diagnosis or can present with frank rupture, or symptoms caused by compression on nearby organs. CASE PRESENTATION: A 44 years old male was diagnosed with rectosigmoid adenocarcinoma and underwent low anterior resection. One year after the surgery, he presented with fistula between the rectal stump and left iliac artery that was managed by stenting. CONCLUSION: A fistula between the rectal stump and the left iliac artery is very rare. There are several treatment options for ilio-rectal fistula but no conclusive specific treatment.

A retrospective cohort report of single-incision laparoscopic cholecystectomies in Saudi Arabia: Postoperative outcomes and patient satisfaction.

Introduction: Single incision laparoscopic cholecystectomy has become more popular recently. Because it yields shorter hospitalization, less postoperative pain, and better cosmetic outcomes. As it minimizes the number of incisions, it causes less trauma to the anterior abdominal wall and this decreases the operative mortality and morbidity. In this study, our aim is to share our results from the procedure so that surgeons in the field may consider adopting this approach when performing a laparoscopic cholecystectomy. Methods: This is a retrospective study of 125 patients that underwent single-incision cholecystectomy. These patients underwent the procedure in a specialized center. We extracted data and surveyed patients who underwent the procedure between 2017 and 2019, and that were performed by the same consultant using the standard tools of laparoscopic surgery. All patients were followed for 12 months. The postoperative survey includes; the cosmetic appearance of the surgical site, pain management after the procedure, and patient satisfaction with this experience. Results: Most of the patients were satisfied with postoperative pain management and their cosmetic appearance. Most of the patients were females diagnosed with cholelithiasis preoperatively. The mean age of the patients was 37.43 ± 10.72 years, the mean BMI of the participants was 29.68 ± 6.51 kg/m2 and the mean operative time was 25.56 ± 10.42 min. Conclusion: Single incision laparoscopic cholecystectomy has the potential to become the procedure of choice for cholecystectomy.

Reversal of primary obesity surgery endolumenal following postoperative complications: A case report.

INTRODUCTION AND IMPORTANCE: Although bariatric surgeries are an increasingly popular option to achieve significant weight loss in patients who fail to do so via conservative measures, these procedures are invasive and carry a risk of complications, many of which are serious and potentially fatal. In this context, endoscopic bariatric therapies (EBT) such as primary obesity surgery endolumenal (POSE) have been proposed as a new minimally invasive weight loss procedure to reduce the risk of postoperative complications. However, these procedures are in their early stages, with only a few cases reported in literature. We report our experience in managing a complicated case of POSE gastroplasty. CASE PRESENTATION: We report a case of a 45-year-old woman presenting with severe epigastric pain and vomiting. She was suffering from postoperative complications following a transoral gastroplasty procedure. The patient was managed surgically to correct the offending complication, which consequently resulted in reversal of POSE. CLINICAL DISCUSSION: Conventional bariatric surgical procedures are generally performed using an open and/or laparoscopic approach. Although highly effective, this approach is associated with significant complications. EBTs are gaining traction as novel treatment modalities for obesity. A major reason for adopting this approach is the fact that endoluminal therapy represents a minimally invasive treatment option for obesity with a minimal rate of complications. CONCLUSION: Due to the fact that POSE reversal has never been reported or discussed, especially in the context of gastric perforation, it is imperative that future studies are conducted on the matter.

Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report.

BACKGROUND: Chylous ascites is considered to be an intra-abdominal collection of creamy colored fluid with triglyceride content of > 110 mg/dL. Chylous ascites is an uncommon but serious complication of numerous surgical interventions. However, it is a rare complication of LRYGB. An internal hernia limb defect is thought to be the underlying etiology, where the hernia will cause lymphatic vessel engorgement and lymphatic extravasation. CASE PRESENTATION: We report a case of a 29 years old male with a 9 year history of laparoscopic Roux en y gastric bypass (LRGYB), presenting with recurrent abdominal pain for 2 months radiating to the right shoulder. Ultrasound examination revealed gallstones and the patient was subsequently admitted for laparoscopic cholecystectomy. Intraoperatively, whitish colored fluid, high in triglycerides content was aspirated. During exploration, an internal hernia limb defect was found and corrected. CONCLUSION: Post LRGYB patients with symptoms of recurrent abdominal pain should be suspected for chylous ascites reflecting an internal hernia.