Background: The round block technique (RBT) is an oncoplastic technique used in the excision of peri-areolar breast lesions especially in small to medium-sized breasts with moderate ptosis. Objective: Our study aims to introduce the technique of modified round block technique (MRBT) and to compare RBT and MRBT in peripherally located tumors as regards the oncological safety and cosmetic outcomes. Patients and methods: From October 2018 to October 2021, a randomized controlled clinical trial was conducted on 40 female patients with early stages of breast cancer. Patients selected had tumors at least 2 cm away from the nippleareola complex (NAC) and an expected excision volume not exceeding 20% of the breast volume. Patients' demographic data and tumor characteristics were recorded and analyzed. Results: The MRBT group has a significantly shorter operative time (P-value 0.016). Positive margin involvement was recorded in 2 cases requiring re-excision in the RBT group. Six patients developed seroma formation which was significantly higher in the MRBT group (P-value 0.048). A significantly lower mean change in areolar diameter was observed in the MRBT group (P-value 0.032). Two cases developed local recurrence, one in each group. No cases of distant metastasis were encountered during the follow-up. MRBT group has a significantly higher cosmetic outcome than RBT (P-value 0.03). Conclusion: The MRBT is an oncoplastic technique suitable for the excision of breast tumors in different breast quadrants especially peripherally located tumors in patients with small to medium-sized breasts and when the excision volume is not exceeding 20% of the breast volume.

Background:The conventional open omental patch repair is the gold standard treatment for peptic ulcer perforation (PUP). Laparoscopic management has been advocated for the treatment of perforated peptic ulcers since 1990, but many concerns still exist about the technique's viability and safety. Objective: The aim of the current study is to compare the results and outcome of open versus laparoscopic repair technique for perforated peptic ulcers. Patients and methods: A total of 73 cases with a preoperative clinically diagnosed with peptic ulcer perforation were distributed randomly into two groups to perform either open or laparoscopic repair with an omental patch comparing their operative and postoperative results. Results:In comparison to open surgery, laparoscopic PUP repair led to quicker oral eating and bowel movements, less postoperative discomfort, less superficial wound infections, fewer pulmonary and overall problems, secondary intervention, and a shorter hospital stay. Its sole drawback was a longer operating time. Conclusions: Laparoscopic technique is a safe and feasible treatment modality for PUP with superior outcome when compared to open surgery.

Introduction:The incorporation of oncoplastic surgery techniques in the management of breast cancer became more popular and offers both oncological safety and good cosmetic results. It is highly challenging for surgeons to obtain good oncological control and acceptable cosmetic results, especially in tumors in the lower quadrant of the breast. The utility of anterior Intercostal Artery perforator flap (AICAP) in immediate reconstruction following breast-conserving surgery (BCS) is rarely described in the literature. In our study, we present our experience with the Anterior Intercostal Artery Perforator flap in 20 patients with small to medium-sized breasts.Patients and methods: From June 2018 to June 2021, twenty female patients underwent quadrantectomy followed by reconstruction using an AICAP flap. Results:The surgical excision margins were negative in all patients and no re-excision was needed. The dimensions of the flap were matching the defect size or were slightly larger due to anticipation of tissue shrinkage post radiation, with a mean of 7 × 5 × 3 cm (range of 4.6-10 × 3-6× 2-5 cm). The postoperative complications were observed in only one patient (5%) in the form of mild wound infection. An average percentage of excellent to good results was obtained in 95% of cases. Conclusion:The AICAP flap is an important addition in the field of oncoplastic immediate reconstruction after BCS, especially in patients with small to moderate breast sizes. The technique is oncologically safe and provides improved aesthetic results after quadrantectomy for tumors in the lower quadrants of the breast.

Background: COVID-19 infection was linked to an increased risk of thromboembolism in high-risk individuals, so different anticoagulants were employed at varying doses. Anticoagulant-induced spontaneous retroperitoneal bleeding (SRB) is a rare condition. Objective: To analyze spontaneous retroperitoneal bleeding (SRB) associated with COVID-19 infection owing to anticoagulation on a larger scale in terms of comorbidities and factors related with SRB, as well as discuss existing therapeutics modalities, factors influencing decision, prognosis, and associated mortality. Patients and Methods: Twenty COVID-19 patients presented with SRB; 12 were treated surgically, and 8 were treated conservatively. Patients' demographic information, comorbidity evaluation, type of intervention, results, and prognostic factors were all evaluated. Results: Eight patients were treated conservatively; three died as a result of refractory shock. Twelve patients were operated on; eight of them died as a result of myocardial infarction, pulmonary problems, and multiple organ failure. The date of the surgical consultation influenced care and outcome significantly. Increased blood component requirements were found to be substantially associated to mortality. Conclusion:Management should be wise, yet not hesitate to intervene if necessary. In a progressive hematoma, this produces better results than conservation. Independent variables that necessitate intervention include vital instability, increasing hemoglobin decline, and transfusion requirements.

Background: More than half of breast cancer lesions occur in the outer quadrant, mostly diagnosed in early stages. Cases with late stages are usually directed to total mastectomy and/or axillary clearance. With the recent interest in oncoplastic surgeries for such cases, we introduce the single incision lateral mammoplasty (SILM) for early as well as certain late stages Patients and methods: 20 female patients diagnosed with invasive breast cancer in the outer breast quadrant, at different stages, were recruited for single incision lateral mammoplasty (SILM). Oncological safety and aesthetic outcomes were assessed.Results: Complete resection of the tumor was possible in all cases, with one patient having wound infection and two having seroma. Excellent or good cosmetic results were reported in 95% of cases. Conclusion:Single incision lateral mammoplasty (SILM) is feasible for outer quadrant breast cancer lesions at different stages, especially in cases where aesthetic outcomes are of concern.