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Background: Surgical treatment of sacrococcygeal pilonidal sinus is associated with significant recurrence rate. However; recent study suggested the use of rhomboid excision and Limberg flap repair as feasible procedure for treatment of pilonidal sinus disease. Our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with Limberg flap by comparing this procedure with the traditional excision and primary closure.Methods: This prospective study included 60 patients with sacrococcygeal pilonidal sinus. The patients were randomly divided into 2 equal groups. Rhomboid excision of the sinus with limberg flap was performed in 30 patients (group A), and excision of the sinus with primary closure was done to the other 30 cases (group B). Demographic data and surgical outcome were compared between both groups.Results: Group A showed significant early retained to work and significant less postoperative pain than group B (P=0.04 and P=0.02 respectively). Incidence of wound dehiscence, postoperative hematoma and seroma was less among group A but without significant difference. The incidence of postoperative infection and recurrence rate was significantly less in group A than group B (P=0.04 and P= 0.035 respectively).Conclusions: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple excision with primary closure in treatment of sacrococcygeal disease. In addition, it is safe and easily procedure; it may be an ideal treatment option in management of pilonidal sinus.

Background: In some hematological diseases, the spleen may become enlarged, inflamed and causes destruction of normal blood elements. Laparoscopic splenectomy (LS) was first prescribed in 1991 by Delaitre et al and since that date, it gained a steadily increasing worldwide agreement as an option for splenectomy in patients with hematological diseases. It was reported that this can be performed safely and effectively, with lower incidence of morbidity and mortality. The objective of the study was to compare laparoscopic with open splenectomy as regard its benefits and hazards in haematological diseases.Methods: This prospective study had been conducted in General Surgery Department, Sohag Faculty of Medicine. The study included patients with haematological diseases indicated for elective splenectomy, during the period from January 2015 to June 2017. Twenty patients were included for open surgery (OS) and 20 cases were included for laparoscopic splenectomy (LS).Results: Surgical time was significantly longer in LS than OS group. There was significant correlation between surgical time and splenic size in both groups. Most of the LS patients had been operated upon using the anterior approach (65%). Hospital stay after operation in the LS group was much less than the OS group. Return of off-bed activities, bowel movements, oral intake and drain removal were longer but not significantly different compared to LS figures.Conclusions: Laparoscopic splenectomy for haematological indications can be done safely for the properly selected patients with less blood loss and hospital stay but it requires more operative time as compared to conventional splenectomy.

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