Sixty patients with subglottic stenosis of acquired and nonneoplastic origin were surgically managed by multiple open procedures. Follow-up ranged from 1 to 10 years. Fifty-seven patients had stable and excellent or good results, 2 of them after further surgery, 1 patient had to live with a retained tracheostomy indefinitely and the remaining 2 patients died. While the whole spectrum of surgical modalities employed in this series may not be recommended with total conviction, the authors express their satisfaction with single resection and end-to-end anastomosis which yields invariably good and rapidly obtainable results (22 cases with complete success). Nevertheless, laryngeal enlargement seems to be essential in the case of upper glottic lesions (19 operations provided 19 successes) while primary resection with moulding plasties may be applicable to complex and extended stenoses (19 operations: 16 successful results and 3 failures). With regard to the choice of operation, the authors emphasize the importance of careful preoperative assessment of the lesions which should assure adequate selection of therapeutic methods according to the degree of associated involvement of the trachea, glottis or supraglottic area. Conservative measures including dilatation, electro-coagulation and laser-beam surgery are considered as palliative only, however, they may be useful either in the course of the patient's preparation or in order to achieve more successful postoperative results.

Objective To compare leakage pressures of colonic anastomoses performed with circular staplers to conventional hand‐sewn techniques in dogs. Study design Ex‐vivo study. Animals Colon from 11 canine cadavers. Methods Thirty‐two colonic anastomoses were performed. Four segments from each colon were randomly assigned to one of four techniques: hand‐sewn colonic anastomoses performed with 4‐0 glycomer 631 (G) and 4‐0 barbed glycomer 631 (BG), and circular stapled colonic anastomoses using 4.8 mm End‐to‐End Anastomosis (EEA C4.8mm) and 3.5 mm End‐to‐End Anastomosis (EEA C3.5mm), 21 mm diameter circular staples in cadaveric canine colon. Leakage pressure was defined as the pressure at which dye‐containing solution was first observed to leak from the anastomosis site. Results Leakage pressures were 49.5 mmHg (range:16‐72) in group G, 45.5 mmHg (range:19‐80) in group BG, 5.3 mmHg (range:0‐31) in group C3.5mm, and 29.5 mmHg (range:23‐50.3) in group C4.8mm. Anastomoses leaked at lower pressures when stapled rather than hand‐sewn (C4.8mm‐G p = .0313, C4.8mm‐BG p = .0131, C3.5mm‐G p = .0469, C3.5mm‐BG p = .0313). Two of the C3.5mm constructs leaked immediately after saline infusion with 4/6 leaking at <5.3 mmHg. Conclusion End‐to‐end colonic anastomoses closed with circular stapler leaked at lower pressures than hand‐sutured anastomoses. Use of the EEA stapler with a staple height of 3.5 mm did not result in safe colonic anastomoses. Clinical significance These results provide evidence to support hand‐suturing colonic anatomoses with G and BG in dogs. The 4.8 mm staples may be considered in anatomical locations difficult to reach.

Objective To evaluate thoracoscopic treatment of persistent right aortic arch (PRAA) in dogs with and without the use of one lung ventilation (OLV). Study Design Retrospective cohort study. Animals Twenty‐two (client‐owned and shelter) dogs diagnosed with PRAA. Methods Medical records were reviewed retrospectively and intraoperative and immediate postoperative data were compared between dogs that underwent thoracoscopic treatment of PRAA with (OLV+) and without (OLV‐) OLV. Results Ten of the 12 dogs in the OLV+ group and 7/10 dogs in the OLV− group had their left ligamentum arteriosum successfully ligated during thoracoscopy. Median surgical time, surgery complications, anesthesia complications, and rate of conversion to an open thoracotomy due to limited visualization or surgical complications were similar between the two groups. Conclusion Thoracoscopic treatment of PRAA can be performed with or without OLV. Surgical time, intraoperative complications, and conversion rates were similar between dogs that underwent thoracoscopic treatment of PRAA with and without OLV. OLV may not have contributed to improved visualization in this group of dogs. Clinical Significance (or Impact) The use of OLV is safe during thoracoscopic treatment of PRAA. OLV did not appear to provide significant benefits in this case series and thoracoscopic treatment of PRAA in dogs may be performed successfully with or without the use of OLV.

Objective To compare conventional and intracorporeal vesicourethral anastomosis (VUA) in canine cadaveric tissue. Study design Cadaveric ex vivo study. Study population Twenty‐eight canine bladders with urethra. Methods Specimens after prostatectomy were randomly divided into intracorporeal (I) group or conventional (C) group. For the I group, VUA was performed in a simulator with laparoscopic needle holders and telescope. For the C group, the anastomosis was performed in vitro with standard instruments. The VUA was performed with 4–0 monofilament absorbable suture and was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and number of suture bites were recorded. Results Fourteen samples were entered in each group. The dorsal side of the anastomosis was initially performed, followed by the ventral side. The median suturing time was 30.8 minutes (range, 19.3–39.2) for the I group and 17.3 minutes (range, 9.2–21.3) for the C group (P < .0001). The median leakage pressure was 10.9 mm Hg (range, 4.1–29.7) for the I group and 10.8 mm Hg (range, 6.2–18.5) for the C group (P = .94). The median number of stitches was 20 (range, 14–26) for the I group and 19 (range, 11–28) for the C group (P = .96). The distribution of the site of leakage was similar between groups (P = .381). Conclusion Vesicourethral anastomosis can be performed with leakage pressures similar to intracorporeal and conventional suturing. Clinical significance This study represents the first step toward laparoscopic radical prostatectomy in dogs.

Laparoscopy has emerged as the preferred operative approach for most intra-abdominal pathologic conditions. Nonetheless, even though the first laparoscopic colectomy was reported more than 20 years ago. 2 Laparoscopic hemicolectomy for colonic cancer can be performed safely with morbidity, mortality and long-term results comparable to those of open surgery. 3 ABSTRACT Background: Laparoscopic hemicolectomy for colonic cancer can be performed safely with morbidity, mortality and long-term results comparable to those of open surgery. Despite these advantages, laparoscopic right hemicolectomy is technically challenging and warrants intensive structured training to minimize conversion to open surgery and associated complications. Anastomosis could be done either by hand sewn or stapler. Methods: Present study was a prospective study. It included 30 patients presented to Menoufia University Hospital and El Salam Oncology Center with carcinoma of right colon from March 2016 until September 2018. The patients were divided into two groups each group of 15 patients. In the first group, author used the hand sewing for anastomosis compared to the stapled anastomosis in the second group. Results: In the first group, 11 of them were males (73.3%) and 4 were females (26.7 %) with the mean age was 55.93±8.64 years. In the second group, 6 of them were males (40%) and 9 were females (60%) with the mean age was 48.33±17.97 years. In the first group, the mean time of anastomosis was 36.0±4.71 minutes and in the second group the mean time of anastomosis was 21.67±5.56 minutes. In the first group, 1 case was complicated by leakage from anastomosis (6.2%), 1 case was complicated by wound infection (6.2%). In the second group, there was no complication. Conclusions: In this study, the main advantages of doing a stapled anastomosis are the operative time, hospital stay and intraoperative bleeding. Postoperative complications than the hand sewn anastomosis.