Laparoscopic appendectomy using our new spiral needle is easy, minimally invasive, and cost effective.

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Background: preoperative chemotherapy can reduce the size of the tumor, thus allow some patients with advanced tumors which is common the opportunity of conserving breast surgery. The aim of the study was to evaluate the efficacy of neoadjuvant chemotherapy (NC) on the possibility of breast-conserving surgery (BCS) in patients for whom mastectomy was the only accepted surgical option. Methods: thirty patients who had stage III breast cancer received neoadjuvant chemotherapy comprised of doxorubicin and cyclophosphamide, followed by surgery between 2016 and 2019. Results: thirty patients included in the study, 27(90%) presented with an invasive ductal carcinoma. The mean tumor size before NC, measured using MRI, was 37 mm (range, 20-75 mm) and 29 mm (range, 12.5-75 mm) after NC. Twenty patients (66.7%) underwent mastectomy while ten patients (33.3%) underwent BCS. The mean follow up survival time for all patients was 32±1.2 months range (29.8-34.8) months with (95% CI; 29.8-34.8).one case (3.3%) of BCS had locoregional recurrence and three cases (10%) had distant metastasis. Patients with IDC had significant higher DFS (33.5 ±1.04) months than patients with combined IDC+ILC (20±6) months and ILC(18) months.Patients with mastectomy had better numerical (not significant) DFS (32.25±1.5) months than patients with BCS (31.6±2.3) months. Conclusion: NC had a role in reducing the size of the tumor and could be applied in patients with advanced carcinoma. It increased the chance of BCS without affecting overall survival.

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