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Assessment and management of low anterior resection syndrome after sphincter preserving surgery for rectal cancer

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Chinese Medical Journal 2020年第15期133卷 1824-1833页

作者： Ahmad Sakr fozan sauri Mohammed Alessa Eman Zakarnah Homoud Alawfi Radwan Torky Ho Seung Kim Seung Yoon Yang Nam Kyu Kim Division of Colorectal Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoul 03722Korea Colorectal Surgery Unit Department of General SurgeryMansoura Faculty of MedicineMansoura University HospitalsMansoura 35511Egypt ‘Department of General Surgery King Faisal UniversityAlahsa 31982Saudi Arabia Department of General Surgery Main hospitalAssiut Faculty of MedicineAssiut UniversityAssiut 71511Egypt

Many patients develop a variety of bowel dysfunction after sphincter preserving surgeries(SPS)for rectal *** bowel dysfunction usually manifests in the form of low anterior resection syndrome(LARS),which has a negative impact on the patients'quality of *** study reviewed the LARS after SPS,its mechanism,risk factors,diagnosis,prevention,and treatment based on previously published *** history taking,physical examination of the patients,using validated questionnaires and other diagnostic tools are important for assessment of LARS *** of LARS should be tailored to each *** therapy is usually needed for patients with major LARS with acceptable *** treatment includes conservative management in the form of medical,pelvic floor rehabilitation and transanal irrigation and invasive procedures including *** this treatment failed,fecal diversion may be *** conclusion,Initial meticulous dissection with preservation of nerves and creation of a neorectal reservoir during anastomosis and proper Kegel exercise of the anal sphincter can minimize the occurrence of ***-treatment counseling is an essential step for patients who have risk factors for developing LARS.

关键词： Bowel dysfunction Low anterior resection syndrome Rectal cancer Sphincter-preserving surgery

Triple synchronous primary neoplasms in the gastrointestinal tract

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Chinese Medical Journal 2021年第10期134卷 1233-1235页

作者： fozan Mohammed sauri Eman Adnan Zakarneh Mohammed Yousef Alessa Ahmad Hammad Sakr Yeon Seung Chung Ho Seung Kim Nam kyu Kim Department of Surgery Colorectal DivisionYonsei University College of MedicineSeoul120-752South Korea Department of General Surgery King Faisal UniversityAlahsa 31982Saudi Arabia Colorectal Surgery Unit Department of General SurgeryMansoura Faculty of MedicineMansoura University HospitalMansoura 35511Egypt Department of Pathology Yonsei University College of MedicineSeoul 120-752South Korea

To the Editor:Most of the multiple primary malignancies are metachronous or involve more than one system,we instead describe a case with synchronous triple cancers involving one organ *** study was approved by the Institutional Review Board of Severance hospital,Yonsei University(IRB No.4-2019-0889).A 61-year old man who had no chronic illness,underwent abdominal computerized tomography(CT)scan due to vague abdominal complains and was found to have descending colon wall thickening[Figure 1A],colon cancer(cT3N+)was *** is not smoker or alcohol drunker,and has no family history of malignancies.

关键词： neoplasms colon Figure

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妊娠期腹腔镜手术的安全性和危险性

世界医学杂志 2003年第11期7卷 11-13页

作者： HayaAl-fozan TogasTulandi 李艳冷金花 ProfessorofObstetricsandGynecologyandtheMiltonLeongChairReproductiveMedicine McGillUniversity687PineAveWestMontrealQuebecH3A1A1Canada 不详

目的：本综述的目的在于评估妊娠期腹腔镜手术的适应证、安全性和有效性，尤其关注其对妊娠结局的影响。最近发现：妊娠期腹腔镜手术中患者的血流动力学改变类似于非妊娠状态。这一过程看起来是安全的，可以减少住院次数和早产发生率。... 详细信息

目的：本综述的目的在于评估妊娠期腹腔镜手术的适应证、安全性和有效性，尤其关注其对妊娠结局的影响。最近发现：妊娠期腹腔镜手术中患者的血流动力学改变类似于非妊娠状态。这一过程看起来是安全的，可以减少住院次数和早产发生率。妊娠期施行腹腔镜手术最安全的时期是妊娠中期。然而，这一过程可能并发损伤妊娠子宫，造成流产。最近的一篇报道证实了此点，充气意外地进入了羊膜腔，所以导致了胎儿丢失。结论：妊娠期腹腔镜手术最常见的适应征有：胆石病、阑尾炎、持续存在的卵巢囊肿和附件扭转。一般来说，腹腔镜手术后母婴结局良好。流产、早产或者胎儿死亡的发生似乎与疾病本身的病理情况相关，而与手术干预无关。由于妊娠子宫引起阑尾位置改变，以及妊娠期白细胞计数的生理性升高。因此，妊娠期阑尾炎的诊断可能被延误，出现并发症。其中一篇报道提到，在无并发症的阑尾炎中，胎儿丢失率为1．5％，若存在阑尾穿孔时，则胎儿丢失率可高达35％。同样，在无并发症的胆囊切除手术中，胎儿丢失率为4％，而结石性胰腺炎患者的胎儿丢失率可高达60％。在妊娠期进行腹腔镜手术时，操作应极其认真仔细。妊娠中期时，极力推荐施行开放性腹腔镜手术。

关键词：妊娠期腹腔镜手术安全性危险性

Obesity in Relation to Ovarian Response in IVF Treatment

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Advances in Reproductive Sciences 2018年第2期6卷 50-57页

作者： Howaida Hashim Mahmoud Gehad Badawi Khalid Fahad Al Salman Samar Hassan Afaf Felemban Haya Al fozan M. Al Bugnah IVF/Reproductive Endocrinology Unit Obstetrics &amp amp Gynecology Department King Abdul Aziz Medical City Riyadh Saudi Arabia IVF Unit OB/GYN Department Dr. Erfan &amp amp Bagedo General Hospital Jeddah Saudi Arabia

Introduction: The effect of Body Mass Index (BMI), which reflects the woman’s obesity, in IVF treatment cycle, remains unclear. In 1997, the World Health Organization (WHO) provided authoritative refinements to the over-weight terminology and BMI cutoffs [1]. Objective: To verify the relationship between BMI and ovarian response in IVF treatment cycle. Design: Retrospective study. Materials & Methods: The study includes 2625 IVF treatment cycles performed in our IVF center in the period of 4 years. Patients were divided into five groups using the WHO criteria according to their BMI [2]. Cancellation rate, mean last E2 before hCG administration, mean endometrial thickness, mean duration of stimulation, number of eggs retrieved, fertilization rate, pregnancy and abortion rates were analyzed. The unpaired t-test was used in statistical analysis. Results: There was statistically significant less mean oestradiol level prior to hCG, less endometrial thickness and less number of simulation days as BMI gets higher. In contrast, there was a positive relationship between cancellation rate and higher BMI except with BMI >39 which was not, possibly due to lower number of patients available. But if we look at the cause of cancellation, it was 100% due to insufficient number of follicles obtained for this group (BMI >39). Also, days of stimulation are significantly lower for the same group of patients in comparison with the other groups. Retrieval, fertilization and pregnancy rates were not significant between all groups. Abortion rate gets significantly higher as BMI increased. Conclusion: Overweight affects ovulation, if we consider the cause of cancellation being insufficient number of follicles reflects the poor response. The fertilization and pregnancy rate were not affected once oocytes retrieved. The reduction of weight is an important part of infertility treatment in obese women with regards to the ovarian response and abortion rate in IVF cycle.

关键词： Body Mass Index IVF Pregnancy Rate

接受超促排卵治疗妇女中来曲唑与枸橼酸克罗米酚疗效的比较:一项随机试验

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世界核心医学期刊文摘（妇产科学分册） 2005年第5期1卷 29-30页

作者： Al-fozan H Al-Khadouri M Tulandi T 王雅楠

To compare the effects of the aromatase inhibitor letrozole (7.5 mg) and clomiphene citrate (CC; 100 mg) in women undergoing superovulatio n and IUI. Prospective randomized trial. University teaching hospital. We studie d a total of 238 cycles of superovulation and IUI in women with idiopathic infer tility. Patients were randomized into treatment with 7.5 mg of letrozole daily ( 74 patients, 115 cycles) or 100 mg of CC daily (80 patients, 123 cycles). Number of follicles, endometrial thickness, pregnancy rate, and miscarriage rate. The mean age, parity, and duration of infertility in both groups of patients were si milar. There was no significant difference between the total number of developin g follicles in the letrozole (5.7 ±3.7) and in the CC groups (4.8 ±2.5). The n umber of follicles of 18 mm were 2.1 ±1.2 and 1.4 ±0.7 in the l etrozole group, and 1.7 ±0.9 and 1.1 ±0.5 in the CC group, respectively. No di fference was found in the endometrial thickness between the two groups (7.1 ±0. 2 mm in the letrozole group, 8.2 ±5.9 mm in the CC group). The pregnancy rate p er cycle was 11.5%in the letrozole group and 8.9%in the CC group. Four of the 11 pregnancies in the CC group resulted in a miscarriage (36.6%). Superovulatio n and IUI with letrozole and CC are associated with similar pregnancy rates, but the miscarriage rate is higher with CC. The ideal dose of letrozole remains unk nown and further study is needed.

关键词：超促排卵克罗米酚来曲唑卵泡数原发性不孕随机试验枸橼酸子宫内膜厚度人工受精流产率