Background and Objectives. The use of complete mesocolic excision (CME) technique seems to be gaining popularity in the management of cancer colon. We aim to compare the laparoscopic approach for CME with the open approach in right colon cancer treatment with regard to the feasibility, safety, and perioperative and oncologic outcomes. Patients and Methods. A prospective study which included all patients that underwent radical right hemicolectomy for pathologic confirmed stage II or stage III tumor with CME at South Egypt Cancer Institute, Assiut University, from January 2012 to December 2019. Patients were grouped according to the surgical approach into the laparoscopic colectomy (LCME) group (n = 48) or open colectomy (OCME) group (n = 48). Results. The mean operative time was significantly longer in the LCME group than that in the OCME group with less mean intraoperative blood loss. Conversion was required in 4 patients (8.3%) in the LCME group. The use of laparoscopy increased the number of harvested lymph nodes compared to the open approach (39.81 ± 16.74 vs. 32.65 ± 12.28, respectively, P = 0.010 ). The laparoscopic approach was associated with a shorter time interval to first flatus as well as shorter time interval to liquid and normal diet after surgery. The postoperative hospital stay was significantly shorter in the LCME group. The complication rate was slightly lower in the LCME (14.7%) than in the OCME group (27.2%) ( P = 0.252 ). The 3-year OS in the LCME group was similar to that in OCME (78.2% vs. 63.2%, respectively, P value = 0.423). The three-year DFS in the laparoscopic group was higher (74.5%) than the open group (60.0%), but did not reach statistical significance ( P value = 0.266). Conclusions. In conclusion, laparoscopic CME right hemicolectomy is a technically feasible and safe procedure if surgeon expertise is present. LCME has long-term oncologic outcomes (recurrence and survival) comparable to open surgery for management of patients with stage II or III colon cancer.

IntroductionIn the surgical treatment of rectal cancer, a clear circumferential resection margin and distal resection margin should be obtained. The aim of this study was to determine the morbidity, mortality, survival outcome, and local failure after total mesorectal excision (TME) in the surgical treatment of rectal cancer.MethodsThis retrospective study was conducted on 101 patients treated for rectal cancer using low anterior resection (LAR), abdominoperinial resection (APR), or Hartmaan’s technique. In all operative procedures, total mesorectal excisions (TMEs) were done. The patients were treated from November 2000 to April 2011 in the South Egypt Cancer Institute (SECI) of Assuit University (Egypt). Neo-adjuvant therapy was given to those patients with serosalin filtration, lymph node involvement, and sexual and urinary function impairment. Data were analyzed using IBM-SPSS version 21, and survival rates were estimated using the Kaplan-Meier method.ResultsOne hundred one patients were evaluable (61 males, 40 females). Regarding the operative procedure used, it was: (APR), LAR, Hartmaan’s technique in 15.8%, 71.3%, and 12.9% of patients, respectively. Operation-related mortality during the 30 days after surgery was 3%. The operations resulted in morbidity in 25% of the patients, anastomotic site leak in 5.9% of the patients, urinary dysfynction in 9.9% of the patients, and erectile dysfunction in 15.8% of the male patients. Regarding safety margin, the median distances were distal/radial margin, 23/12 mm, distal limit 7 cm. Median lymph nodes harvest 19 nodes. Primary tumor locations were anteriorly 23.8%, laterally 13.9%, posteriorly 38.6%, and circumferential 23.8%. Protective stoma 16.8%. Primary Tumor TNM classification (T1, T2, T3, and T4; 3, 28.7, 55.4, and 12.9%, respectively). Nodes Metastases (N0, N1, and N2; 57.4, 31.7, and 10.9%, respectively). TNM staging (I, II, III, and IV; 15.8, 29.7, 46.5, and 7.9%, respectively). Chemotherapy was administered to 67.3% of the patients. Radiotherapy (short course neoadjuvant, long course neoadjuvant, and adjuvant postoperative used in 33.7, 20.8, and 19.8% of patients, respectively). Survival 5-years CSS was 73% and 5-years RFS 71%. Mean operative time was 213 minutes. The average amount of intraoperative blood loss was 344 mL.ConclusionTotal mesorectal excision (TME) represents the gold-standard technique in rectal cancer surgery. It is safe with neoadjuvent chemoradiotherapy and provides both maximal oncological efficiency (local control and long-term survival and maintenance of a good quality of life).

Background: The intersphincteric resection the most extreme form of a sphincter-preserving alternative for the abdominoperineal resection. Aim of the Work: We investigated oncological, functional outcomes and morbidity after ISR. Methods: This retrospective study included 164 patients who underwent ISR with between 2010 and 2015, Male 56.1%, Female 43.9%, with a median age was 54.5 years, Median follow-up time was of 48 months, Average surgical time was 230 min, Median blood loss was 700 mL and median hospital stay was nine days. Mean tumour size was 34 mm. The surgical procedure through a laparotomy (72.

PurposeThe aim of this study was to evaluate sexual desire in a sample of married Egyptian women with polycystic ovarian syndrome (PCOS). Patients and methodsThis study was carried out on 85 married Egyptian women with PCOS and 63 normal married women (the control group) recruited from the gynecology and obstetrics clinic in Kasr El-Aini Hospital, Cairo University. Every case was subjected to full medical history, full sexual history, general and local examinations, and investigated for serum levels of luteinizing hormone, follicle-stimulating hormone, and testosterone. Pelvic ultrasound was performed and BMI was calculated. Each case was interviewed using a structured interview to answer the translated Arabic version of Female Sexual Desire Questionnaire (FSDQ) developed by Goldhammer and McCabe (2011). ResultsTotal FSDQ score showed significantly higher level in the control group compared with the PCOS group (Po0.001). Except for the solitary desire score, which was higher in the PCOS group than in the control group (P = 0.02), all other domains of the FSDQnamely, dyadic desire, resistance, positive relationship, concern, and sexual self-image -exhibited statistically significantly higher level in the control group ((Po0.001) than in the PCOS group. Among PCOS women, there was significantly higher FSDQ score among women without androgenic alopecia (P = 0.02) and with normal testosterone level (P = 0.04). Conclusion PCOS had a negative impact on female sexual desire. Although PCOS patients suffered from hyperandrogenism, they experienced decreased sexual desire, lacked the responsive sexual desire, and were less satisfied with the relationship with their partner. They were less confident with their bodies and experienced distress in relation to their sexual desire level. The presence of higher level of testosterone or androgenic alopecia in PCOS women is associated with reduced sexual desire.

Background: The molecular mechanism associated with remission of primary gastric lymphoma post helicobacter pylori eradication is still unclear. Aim of the study: to evaluate Microsatellite (MSI) instability at markers adjacent to Chromosomal loci involved in primary gastric lymphoma in relation to helicobacter eradication therapy. Methods: 107 primary gastric lymphoma patients included 30 low grade Mucosa Associated Lymphoid Tissue Gastric lymphoma (MALT), 36 Diffuse large gastric lymphoma with MALT component (MALTDLBCL) and 41 DLBCL gastric lymphoma (DLBCL) were treated with anti Helicobacter pylori therapy as fi rst line treatment and to asses for Microsatellite instability (MSI) Results: the incidence of complete remission post helicobacter pylori eradication was higher in Low grade MALT in comparison to MALTDLBCL and denovo DLBCL. The incidence of MSI is decrease post helicobacter pylori eradication in all subtypes Conclusion: Remission of gastric lymphoma post Helicobacter eradication may associate with correction of MSI level.