Objectives: In Oman, the most frequent indication for a splenectomy in children is sickle cell disease (SCD), which is one of the most common haematological disorders in the Gulf region. This study aimed to describe paediatric laparoscopic splenectomies alone for SCD at a tertiary hospital in Oman. Methods: This study was conducted between February 2010 and October 2015 at the Sultan Qaboos University Hospital, Muscat, Oman. The medical records of all children aged ≤15 years old undergoing splenectomies during the study period were reviewed. Results: A total of 71 children underwent laparoscopic splenectomies during the study period; of these, 50 children (28 male and 22 female) underwent laparoscopic splenectomies alone for SCD. The children's weight ranged between 11-43 kg. The most common indication for a splenectomy was a recurrent splenic sequestration crisis (92%). Surgically removed spleens weighed between 155-1,200 g and measured between 9-22 cm. Operative times ranged between 66-204 minutes and intraoperative blood loss ranged between 10-800 mL. One patient required conversion to an open splenectomy. Postoperative complications were noted in only four patients. The median hospital stay duration was three days. Conclusion: Among this cohort, the mean operating time was comparable to that reported in the international literature. In addition, rates of conversion and postoperative complications were very low. These findings indicate that a laparoscopic splenectomy alone in paediatric patients with SCD is a feasible option.

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ObjectivesTo compare the efficacy and safety of ethanolamine oleate (EO) as a sclerosing agent, vs. absolute ethanol (AE), in the treatment of symptomatic simple renal cysts.Patients and methodsBetween November 2009 and October 2012, 46 patients were prospectively randomised into two groups. All patients presented with a simple renal cyst underwent ultrasonographic aspiration and injection of a sclerosing agent. In group 1, 25 patients had the cyst injected with EO, and in group 2, 21 were treated with AE. One injection was used in cysts of <200 mL and two injections were used in larger cysts. Complete and partial success were defined as complete cyst ablation or a >50% reduction in cyst volume with symptomatic relief, respectively. Patients were followed up using semi-annual ultrasonography and computed tomography for 2 years.ResultsSclerotherapy was technically successful in all patients. There was no significant difference in cyst volume between the groups. After ≈2 years of follow-up there was complete symptomatic relief in both groups, and the overall radiological success rate was 100% of both groups, at 79% complete and 21% partial in group 1, and 83% complete and 17% partial in group 2. The frequency of transient complications in the form of microscopic haematuria was 7% and 13%, and of low-grade fever in 4% and 10% in groups 1 and 2, respectively.ConclusionEO can replace AE as a sclerosing agent for symptomatic simple renal cysts, as it has comparable efficacy with higher safety and tolerance.

Introduction: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammation of the nose and paranasal sinus (PNS) mucosa for at least 12 weeks with the formation of nasal polyps. This is a multi-factorial disease. Nasal polyposis represents 4% of the population. Few studies have looked at the histopathological changes in ethmoid mucosa and compared them with those of the mucosa of the nasal septum, inferior turbinate (IT), and middle turbinate (MT) in patients with CRS. Objective: To compare clinical and histopathological findings of the middle turbinate and ethmoidal polyp in CRSwNP patients refractory to medical treatment. Methods: Forty patients with CRSwNP refractory to treatment were included. Endoscopic and histopathological findings of MT and ethmoid sinus samples were compared. Results: By endoscopic(macroscopic) examination, there was a statistically significant difference between MT and ethmoidal polyp. Polyps in the ethmoid were present in all cases. Polypoidal MT mucosa was present in a quarter of patients. In the rest of the patients, the MT mucosa was edematous or normal. By microscopic examination, there was no statistically significant difference between the two sites in the degree of basement membrane (BM) thickness, goblet cell hyperplasia, eosinophils, and polymorphs. Statistically, a significant difference was present in the degree of sub-epithelial edema, the number of sub-mucous glands, and lymphocytes. Conclusion: Although MT does not share the macroscopic changes with the ethmoid sinus in patients with CRSwNP, at the microscopic level, both sites share the pathologic changes to a far extent. It is better to address the MT in the medical and surgical management of CRSwNP for better results.

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