Background: Rectal carcinoma constitutes a health problem, previously managed with abdomino-perineal resection (APR) which has the impact of poor patient quality of life. With the introduction of the concept of total mesorectal excision (TME) and stapler technology, sphincter saving surgery (SSS) with its better local control and functional status is a better choice than APR. We tried to evaluate the operative safety, long-term oncologic and functional outcomes of SSS in rectal carcinoma.Patients and methods: Between October 2008 and October 2012, patients with rectal carcinoma who presented electively to Sohag University Hospital underwent SSS based on sharp mesorectal excision in the form of anterior resection, low anterior resection and intersphincteric resection were evaluated. Patients were followed up for four years.Results: A total of 60 patients underwent SSS, regarding operative complications; there were 2 ureteric injuries and one bladder injury. Postoperatively, anastomotic leakage occurred in 6.7% of cases. Local recurrence and distant metastases were detected in 8.3% 13.3% respectively. During follow-up, disease-free survival rate was 66.9%, overall survival rate was 93%, 22% of patients had a degree of incontinence. 21.66% had temporary bladder dysfunction. Sexual dysfunction became evident in 30% of male patients. Conclusion:SSS with TME provides a better alternative to APR in rectal carcinoma when feasible.

Background and aim: Minimally invasive procedures; laparoscopic cholecystectomy (LC) and Mini-Laparotomy cholecystectomy (MC), have largely replaced the traditional cholecystectomy. The aim of our study was to compare short term outcomes of LC versus MC for the treatment of gallstones. Patients and methods: This is a prospective study that included patients with gallstones who were referred, randomized and enrolled in the study for elective LC or MC at Sohag University hospital, Egypt; between December 2012 and December 2014. Operation, anaesthesia, rescue analgesics and postoperative care were standardized. The patients were assessed for operation time as primary outcome; length of hospital stay, postoperative pain, and surgical conversion and perioperative complications as secondary outcomes. The patient's outcome was recorded up to four weeks postoperative. Results: Of 220 patients, 110 underwent LC and 110 underwent MC. The mean operative time for MC group was 42.3 ±14.7 which was significantly lower than LC 52.1 ± 19.5 (p value 0.018). There was no statistically significant difference in both groups as regard length of hospital stay, post operative pain, and conversion rate or perioperative complications. Conclusion: MC is an appropriate minimal invasive procedure for cholecystectomy without the financial resources for laparoscopic equipment and rightly trained surgical teams.