This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.  

The aim of the study is to declare the role of surgery in potentially curative malignant pancreatic neuroendocrine tumors, in term of prognosis, survival and complications after the surgical procedures. Does the surgery plays a significant role in the best patient's interest even in metastatic pancreatic neuroendocrine tumors? Clinical and pathological factorsthat changed the outcomes were also analyzed. It is retrospective, case series study. All patients who were undergoing surgery for malignant pancreatic neuroendocrine tumors from 2013 to 2018. Results show that, sixteen patients were recruited with a mean age at diagnosis of 49.31 years, (ranging from 19-80 years). There were 8 male and 8 female patients. Common symptoms were abdominal pain 12 (75%) of them three cases had clinical jaundice 3 (18.8%) and one case had acute pancreatitis and pancreatic necrosis. One (6.3%) patient had functional tumor, and the rest 15 (93.8%) (P-value 0.027), lymph node metastases (P-value 0.027) and tumor stage (P-value 0.017) were associated with recurrent disease. The overall 5 year survival was 81.2% and the disease free survival was (75%) at 5 year, with grade of tumor (Pvalue 0.001), lymph node metastases (P-value 0.001), invasion of other visceral organs(P-value 0.018) and recurrence (P-value 0.001)were associated with decreased survival. In conclusion, pancreatic neuroendocrine tumors have favorable long-term survival after surgical resections even in the presence of liver metastases depending on the grade of differentiation of tumor and lymph node metastases rather than liver metastases and other factors. were nonfunctional tumors; all of the patients were sporadic pancreatic neuroendocrine tumors. Overall morbidity was (43.8%) with no perioperative mortality. The median follow-up period was 23 months, ranging from 5-68 months. Recurrence occurred in four cases with a median disease-free interval of 9.5 moths with grade of differentiation