Introduction and Aim: Laparoscopic sleeve gastrectomy (LSG) considered the gold standard for management of morbid obesity, but, it has serious complications. Laparoscopic greater curvature plication (LGCP) is a restrictive procedure to lower the complications of LSG with the advantage of being a reversible procedure. The current work was designed to compare between Laparoscopic sleeve gastrectomy and greater curve plication in management of morbid obese patients with hiatus hernia. Methodology: This study included 40 morbidly obese patients with hiatal hernia, who underwent laparoscopic Nissen Fundoplication with Greater Curvature Plication (Group A) or Laparoscopic Crural Repair with Sleeve Gastrectomy (Group B). Results: Vomiting was the most common postoperative complaint. Two out of 20 patients (10%) In cases of LGCP developed prolonged nausea, vomiting and sialorrhea for 5 and 7 days but subsided subsequently with antiemetics, proton pump inhibitors, and prokinetics. Intraoperative hemorrhage in two cases of LGCP, Two out of 20 patients (10%) In cases of LGCP developed prolonged nausea, vomiting and sialorrhea for 5 and 7 days but subsided subsequently with antiemetics, proton pump inhibitors, and prokinetics. Four patients of 20 patients (20%) In cases of LGCP developed weight regain and sleeve gastrectomy revision was obtained by performing re-laparoscopy. Conclusion: LSG is a better procedure than LGCP as the most important disadvantage of Laparoscopic gastric plication are that it causes a high rate of recurrence and occurrence of early postoperative complaints.

No abstract

Background: Thyroid nodules are the most common disorder of thyroid gland. In Egypt, nodular goiter occurs in 4%-7% of the population. New radiological imaging techniques might be promising for the differential diagnosis of thyroid nodularity's.Objective: to determine the diagnostic role of diffusion weighted imaging (DWI) in the differentiation of malignant and benign thyroid nodules by using histopathological study as the reference standard.Patients and Methods: 35 patients were included in this study (28 females and 7 males), their ages vary from (12 years to 75 years) with mean age of 48.65 (±14.72). All patients were referred to the surgical department, El Houssin University Hospital in the time period from July 2018 to August 2019 with thyroid gland enlargement. Results: In our study, there were 7(20.6%) males and 28 (80%) females in the patients group. Percentage of benign thyroid nodule was 52.9%. Percentage of malignant thyroid nodules was 47.1%. apparent diffusion coefficient (ADC) value was calculated for both benign and malignant nodules, the range of ADC values for benign thyroid nodules were (0.03 to 3.5) of mean (1.86 ± 0.82) and (0.5 to 1.5) of mean (1.04 ± 0.2), p value was significant with a cut off value 1.2 with 93% sensitivity and 83% specificity.Conclusion: DWI provides very useful and promising results on the nature of a thyroid nodule. Even these results may have a role in the selection of nodules that were going to undergo fine-needle aspiration cytology (FNAC). Although these results were promising, further investigations are needed with larger patient groups.

Background: Haemorrhoidal disease is probably the most frequent reason for consultation in proctology with an estimated prevalence about 4.4%. The gold standard treatment is still excisional hemorrhoidectomy, which is considered a safe and definitive method. Objective: The study was designed to compare the clinical and functional outcome of Doppler-guided (DG) haemorrhoidal artery ligation (HAL) and conventional haemorrhoidectomy for treatment of grade III & IV haemorrhoids.Patients and methods: This study was conducted on 60 patients, divided into two groups: group A included 30 patients that were operated upon through the conventional haemorrhoidectomy and group B include 30 patients that were operated upon through Doppler-guided haemorrhoidal artery ligation (DG-HAL), and comparison between two groups as regard outcomes and complications. Results: It was found from this study that DG-HAL is a painless, easily learned, and minimally invasive therapeutic technique that offers a good alternative to all other known treatments of symptomatic hemorrhoids. During the postoperative check-up 6 weeks after the procedure, scar tissue that had been firmly connected to the underlying tissue structure was seen in areas where ligatures had been placed. Conclusion: Using DG-HAL complications are comparable with those associated with other methods, with no severe complications. The DG-HAL procedure is synonymous with a high level of patient comfort and is perfect for outpatient treatment.