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Totally Endoscopic (Thoracoscopic and Laparoscopic) Radical Esophagectomy with Gastric Tube Reconstruction through a Small Neck Incision: An Early Experience with Thirty Egyptian Patients

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Surgical Science 2014年第5期5卷 214-223页

作者： adel denewer adel Fathi Ahmed Setit Mohamed Hegazy Ashraf Khater Osama Hussein Sameh Roshdy Fayez Shahatto Fathy denewer Department of Surgical Oncology Oncology Center (OCMU) Faculty of Medicine Mansoura University Mansoura Egypt

Background: Minimally invasive esophagectomy nowadays is replacing the classic open technique. Additional studies are needed to confirm its safety and efficacy. Methods: thirty patients with esophageal carcinoma were enrolled in this study. Patients were evaluated preoperatively and they underwent thoracoscopic and laparoscopic procedures for assessment of resectability. Resectablepatients underwent radical esophagectomy with gastric tube reconstruction through a four-cm neck incision. Results: 17 patients were operable and 13 patients were inoperable. The mean operative time for the whole procedure was 5.97 ± 1.66 hours. The mean blood loss was 250 ± 138.07 cc. The mean overall hospital stay was 17.47 ± 5.49 daysdays. Common postoperative complications included pneumonia (13.3%) pleural effusion (6.7%), cervical anastomotic leakage (10%), and wound infection (13.3%). One patient died in the early postoperative period. Conclusions: we conclude that totallyendoscopic (thoracoscopic and laparoscopic) esophagectomy is feasible and relatively safe technique. Beside its efficacy as an assessment tool, total esophagectomy and lymphadenectomy could be performed in the same time.

关键词： Thoracoscopic Laparoscopic Radical Esophagectomy Gastric Reconstruction Esophagus Cancer

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Evaluation of Inferior Pedicle Therapeutic Mammoplasty as a Primary Procedure for Upper Quadrants Early Breast Cancer

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Advances in Breast Cancer Research 2013年第3期2卷 86-90页

作者： adel denewer Waleed Elnahas Osama Hussein Ashraf Khater Wael El-sadda Khaled M. Abouelkher Mansoura Oncology Center Mansoura Egypt

Background: The treatment of breast cancer in large breast patients represents a great challenge to both surgical oncologist and radiation oncologist. The aim of this study is to evaluate the outcome of inferior pedicle therapeutic mammoplasty in large-breasted patients with upper quadrants early breast cancer. Methods: Thirty five large-breasted patients with early breast cancer were included in this study. Simultaneous bilateral inferior pedicle therapeutic mammoplasty was performed. Results: The age of the patients is ranged from 36 to 61 (median 46) years and tumour size is ranged from one to three and half cm. The weight of tissue removed is ranged from 350 gm to 780 gm and the tumour safety margins are ranged from three to eight cm. Wound dehiscence was the commonest post operative complications and six patients were affected (17.6%). The cosmetic outcome was excellent in 22 patients (64.5%), nine patients (26.5%) showed good results, two patients (6%) were satisfactory and one patient (3%) showed poor result. The follow up period is ranged from 6 to 42 months with one case (3%) of systemic metastasis. Conclusion: Inferior pedicle therapeutic reduction mammoplasty for upper quadrants early breast cancer in large breasted women is a surgically and oncologically safe procedure, and it carries a satisfactory aesthetic outcome.

关键词： Breast Cancer Conservative Surgery Reduction Therapeutic Mammoplasty

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The Effectiveness of Intraoperative Frozen Section Analysis of Safety Margins in Breast Conserving Surgery and the Role of Surgeon in Decreasing the Rate of Positive Margins

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Surgical Science 2017年第12期8卷 499-509页

作者： Omar Farouk Ahmed Senbel Mosab Shetiwy Essam Attia Ahmed Abdallah Osama El-Damshety Ashraf Khater Sameh Roshdy Amr Abouzid Amr Hossam Islam H. Metwally Omar Hamdy Amir M. Zaid Mahmoud Abdelaziz Mohamed Elmetwally adel Fathi Emad-Eldeen Hamed Khaled Abdel Wahab Wagdi El-Kashef Mohamed Hafez Khaled Zalata Mohamed Hegazy adel denewer Surgical Oncology Department Oncology Center Faculty of Medicine Mansoura University Mansoura Egypt Pathology Department Faculty of Medicine Mansoura University Mansoura Egypt

Introduction: Nowadays the more accepted surgical option for treating early breast cancer is breast conserving surgery. The main challenge in this type of surgery is to get free safety margins without need of second surgical operation, so many breast surgeons have started to depend on intraoperative frozen sections to ensure free safety margins. Aim of work: To assess our policy that we prefer to depend on intraoperative frozen section analysis to get free safety margin in breast conserving surgery from the 1st surgery, and its oncologic outcome. Patients and Methods: This is a retrospective study conducted in Oncology Center—Mansoura University (OCMU), where the data of 219 patients with breast cancer, who were managed by breast conserving surgery with intraoperative frozen section analysis of the safety margins, was analyzed. Results: The intraoperative frozen section analysis of safety margin was negative from the start in 183 (83.6%) patients, while it was positive in 36 patients (16.4%). Intraoperative decision of margin re-excision was applied for 29 patients (13.2%) in order to reach negative margin, modified radical mastectomy was offered for 4 patients (1.8%), while nipple sparing mastectomy with immediate breast reconstruction using latissimus dorsi flap was offered for 3 patients (1.4%). The postoperative paraffin results were typical with intraoperative frozen section analysis results in 216 patients (98.6%) and different results were obtained in only 3 patients (1.4%) who were managed by modified radical mastectomy in a second operation. Only 4 patients had local recurrence (1.8%) during the period of follow-up duration which was ranged from 1 to 86 months with mean ± SD (22.3 ± 14.1). Conclusion: The intraoperative frozen section analysis of safety margins in breast conserving surgery has very high-rate typical results with the paraffin section analysis and it is very helpful in decreasing the rate of second surgical operation in cases of infiltrated m

关键词： Breast Conserving Surgery Intraoperative Frozen Section Analysis Safety Margins Breast

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