Background: Breast-conserving surgery plus radiotherapy is firmly established as a good and safe option for most women with early breast cancer. Cosmoses after Breast-conserving surgery depend on two main factors; the site of the lesion and the breast volume excised in relation to total breast volume. Latissimus dorsi miniflap is one of the various autologous tissue reconstructions that can replenishe loss of more than 25% of breast volume. The aim of our study is to evaluate the aesthetic outcome and complications of breast reconstruc-tion using latissimus dorsi miniflap augmentation after wide local excision of the tumor combined with axillary lymph node dissection. Patients and Methods: The study involved twenty eight patients with breast cancer underwent conservative breast surgery in the form of wide local excision with safety margin with immediate reconstruction using Latissimus dorsi miniflap either by muscle only or musculocutaneous flap. Neoadjuvant chemotherapy was given in some cases to reduce the tumor size and after surgery; all cases received eligible adjuvant therapy. Results: Most of the patients (71.4%) were having T2 tumor, while (14.3%) of the patients had T1 tumor and (14.3%) had T3 tumor. Neoadjuvant chemotherapy was given for 14 patients with overall response rate about 76.7%. Wide local excision with safety margin with immediate reconstruction using latissimus dorsi mini-flap was done. Seventeen patients had reconstruction with muscle only, while 11 patients had reconstruction by musculocutaneous flap. A deeply satisfied cosmetic result was achieved in (82.1%) and none of them subsequently required mastectomy. After median follow-up of 28 month, the progression free survival was 92.9% and the over all survival was 96.4%. No local recurrence was recorded. Conclusion: Breast augmentation with autologous tissue comes into play by reducing the resultant deformity when the breast volume excised is significant. The Latissimus dorsi flap is the mainstay of oncoplastic breast surgery after partial mastectomy and it has low donor site morbidity, deep patient satisfaction and low and temporary radiation effects.

Background: Breast-conserving surgery plus radiotherapy is firmly established as a good and safe option for most women with early breast cancer. Cosmoses after Breast-conserving surgery depend on two main factors; the site of the lesion and the breast volume excised in relation to total breast volume. Latissimus dorsi miniflap is one of the various autologous tissue reconstructions that can replenishe loss of more than 25% of breast volume. The aim of our study is to evaluate the aesthetic outcome and complications of breast reconstruc-tion using latissimus dorsi miniflap augmentation after wide local excision of the tumor combined with axillary lymph node dissection. Patients and Methods: The study involved twenty eight patients with breast cancer underwent conservative breast surgery in the form of wide local excision with safety margin with immediate reconstruction using Latissimus dorsi miniflap either by muscle only or musculocutaneous flap. Neoadjuvant chemotherapy was given in some cases to reduce the tumor size and after surgery; all cases received eligible adjuvant therapy. Results: Most of the patients (71.4%) were having T2 tumor, while (14.3%) of the patients had T1 tumor and (14.3%) had T3 tumor. Neoadjuvant chemotherapy was given for 14 patients with overall response rate about 76.7%. Wide local excision with safety margin with immediate reconstruction using latissimus dorsi mini-flap was done. Seventeen patients had reconstruction with muscle only, while 11 patients had reconstruction by musculocutaneous flap. A deeply satisfied cosmetic result was achieved in (82.1%) and none of them subsequently required mastectomy. After median follow-up of 28 month, the progression free survival was 92.9% and the over all survival was 96.4%. No local recurrence was recorded. Conclusion: Breast augmentation with autologous tissue comes into play by reducing the resultant deformity when the breast volume excised is significant. The Latissimus dorsi flap is the mainstay of oncoplastic breast surgery after partial mastectomy and it has low donor site morbidity, deep patient satisfaction and low and temporary radiation effects.

Background: Breast-conserving surgery plus radiotherapy is firmly established as a good and safe option for most women with early breast cancer. Cosmoses after Breast-conserving surgery depend on two main factors; the site of the lesion and the breast volume excised in relation to total breast volume. Latissimus dorsi miniflap is one of the various autologous tissue reconstructions that can replenishe loss of more than 25% of breast volume. The aim of our study is to evaluate the aesthetic outcome and complications of breast reconstruc-tion using latissimus dorsi miniflap augmentation after wide local excision of the tumor combined with axillary lymph node dissection. Patients and Methods: The study involved twenty eight patients with breast cancer underwent conservative breast surgery in the form of wide local excision with safety margin with immediate reconstruction using Latissimus dorsi miniflap either by muscle only or musculocutaneous flap. Neoadjuvant chemotherapy was given in some cases to reduce the tumor size and after surgery; all cases received eligible adjuvant therapy. Results: Most of the patients (71.4%) were having T2 tumor, while (14.3%) of the patients had T1 tumor and (14.3%) had T3 tumor. Neoadjuvant chemotherapy was given for 14 patients with overall response rate about 76.7%. Wide local excision with safety margin with immediate reconstruction using latissimus dorsi mini-flap was done. Seventeen patients had reconstruction with muscle only, while 11 patients had reconstruction by musculocutaneous flap. A deeply satisfied cosmetic result was achieved in (82.1%) and none of them subsequently required mastectomy. After median follow-up of 28 month, the progression free survival was 92.9% and the over all survival was 96.4%. No local recurrence was recorded. Conclusion: Breast augmentation with autologous tissue comes into play by reducing the resultant deformity when the breast volume excised is significant. The Latissimus dorsi flap is the mainstay of oncoplastic breast surgery after partial mastectomy and it has low donor site morbidity, deep patient satisfaction and low and temporary radiation effects.

Background: Breast-conserving surgery plus radiotherapy is firmly established as a good and safe option for most women with early breast cancer. Cosmoses after Breast-conserving surgery depend on two main factors; the site of the lesion and the breast volume excised in relation to total breast volume. Latissimus dorsi miniflap is one of the various autologous tissue reconstructions that can replenishe loss of more than 25% of breast volume. The aim of our study is to evaluate the aesthetic outcome and complications of breast reconstruc-tion using latissimus dorsi miniflap augmentation after wide local excision of the tumor combined with axillary lymph node dissection. Patients and Methods: The study involved twenty eight patients with breast cancer underwent conservative breast surgery in the form of wide local excision with safety margin with immediate reconstruction using Latissimus dorsi miniflap either by muscle only or musculocutaneous flap. Neoadjuvant chemotherapy was given in some cases to reduce the tumor size and after surgery; all cases received eligible adjuvant therapy. Results: Most of the patients (71.4%) were having T2 tumor, while (14.3%) of the patients had T1 tumor and (14.3%) had T3 tumor. Neoadjuvant chemotherapy was given for 14 patients with overall response rate about 76.7%. Wide local excision with safety margin with immediate reconstruction using latissimus dorsi mini-flap was done. Seventeen patients had reconstruction with muscle only, while 11 patients had reconstruction by musculocutaneous flap. A deeply satisfied cosmetic result was achieved in (82.1%) and none of them subsequently required mastectomy. After median follow-up of 28 month, the progression free survival was 92.9% and the over all survival was 96.4%. No local recurrence was recorded. Conclusion: Breast augmentation with autologous tissue comes into play by reducing the resultant deformity when the breast volume excised is significant. The Latissimus dorsi flap is the mainstay of oncoplastic breast surgery after partial mastectomy and it has low donor site morbidity, deep patient satisfaction and low and temporary radiation effects.

Abstract Laparoscopy assisted distal gastrectomy (LADG) was first reported in 1994. Since then, it has gradually gained maturity. This procedure is less invasive than conventional open gastrectomy, and the oncologic outcomes are comparable. Recently, single-incision la- paroscopic surgery (SILS) has been developed, which seems to be less invasive than conventional laparoscopic surgery. However, SILS technique is characterized by a limited working area, crowding and crossing of instruments which make it difficult to be applied for oncologic gas- trectomy. In a trial to overcome SILS difficulties, the au- thors report their initial clinical experience of LADG with D1 lymphadenectomy using a novel 3-ports technique. Twenty-one patients have been enrolled for 3-ports la- paroscopic gastrectomy. The patient’s demographic and perioperative data have been collected prospectively. The mean operative time in the first ten cases was 170 min and for the last eleven cases was 140 min (P = 0.01). The mean estimated blood loss was 65 ml. There was no use for additional ports or conversion to open surgery. There were no intra-operative major complications. The mean time for hospital stay was 9 days. One case of pneumonia and one death were the postoperative complications. The mean number of retrieved lymph nodes was 21 and all the cases had free surgical margin. Three-ports LADG with D1 lymphadenectomy could be a safe and oncologically fea- sible procedure; however, a prospective randomized controlled trial comparing three ports LADG with con- ventional multi-ports LADG is required. It is a step towards three-port total laparoscopic distal gastrectomy.

Abstract Laparoscopy assisted distal gastrectomy (LADG) was first reported in 1994. Since then, it has gradually gained maturity. This procedure is less invasive than conventional open gastrectomy, and the oncologic outcomes are comparable. Recently, single-incision la- paroscopic surgery (SILS) has been developed, which seems to be less invasive than conventional laparoscopic surgery. However, SILS technique is characterized by a limited working area, crowding and crossing of instruments which make it difficult to be applied for oncologic gas- trectomy. In a trial to overcome SILS difficulties, the au- thors report their initial clinical experience of LADG with D1 lymphadenectomy using a novel 3-ports technique. Twenty-one patients have been enrolled for 3-ports la- paroscopic gastrectomy. The patient’s demographic and perioperative data have been collected prospectively. The mean operative time in the first ten cases was 170 min and for the last eleven cases was 140 min (P = 0.01). The mean estimated blood loss was 65 ml. There was no use for additional ports or conversion to open surgery. There were no intra-operative major complications. The mean time for hospital stay was 9 days. One case of pneumonia and one death were the postoperative complications. The mean number of retrieved lymph nodes was 21 and all the cases had free surgical margin. Three-ports LADG with D1 lymphadenectomy could be a safe and oncologically fea- sible procedure; however, a prospective randomized controlled trial comparing three ports LADG with con- ventional multi-ports LADG is required. It is a step towards three-port total laparoscopic distal gastrectomy.

Abstract Laparoscopy assisted distal gastrectomy (LADG) was first reported in 1994. Since then, it has gradually gained maturity. This procedure is less invasive than conventional open gastrectomy, and the oncologic outcomes are comparable. Recently, single-incision la- paroscopic surgery (SILS) has been developed, which seems to be less invasive than conventional laparoscopic surgery. However, SILS technique is characterized by a limited working area, crowding and crossing of instruments which make it difficult to be applied for oncologic gas- trectomy. In a trial to overcome SILS difficulties, the au- thors report their initial clinical experience of LADG with D1 lymphadenectomy using a novel 3-ports technique. Twenty-one patients have been enrolled for 3-ports la- paroscopic gastrectomy. The patient’s demographic and perioperative data have been collected prospectively. The mean operative time in the first ten cases was 170 min and for the last eleven cases was 140 min (P = 0.01). The mean estimated blood loss was 65 ml. There was no use for additional ports or conversion to open surgery. There were no intra-operative major complications. The mean time for hospital stay was 9 days. One case of pneumonia and one death were the postoperative complications. The mean number of retrieved lymph nodes was 21 and all the cases had free surgical margin. Three-ports LADG with D1 lymphadenectomy could be a safe and oncologically fea- sible procedure; however, a prospective randomized controlled trial comparing three ports LADG with con- ventional multi-ports LADG is required. It is a step towards three-port total laparoscopic distal gastrectomy.

Background: Laparoscopic colectomy has been shown to have significant short- and long-term benefits compared to open approach. The incorporation of laparoscopy in developing countries is challenging, due to the high costs of equipment and lack of expertise. The aim of this study was to evaluate the safety and feasibility of laparoscopic colorectal surgery for cancer that could be performed in developing countries under different circumstances in developed countries. Methods: Thirty-seven patients (23 males and 14 females) with colorectal cancer with a median age of 46 years (39–72) have been enrolled for laparoscopic colo-rectal surgery in a tertiary center in Egypt (South Egypt Cancer Institute) with the trend of reuse of some disposable laparoscopic instruments. Results: The median operative time was 130 min (95–195 min). The median estimated blood loss was 70 ml (30–90 ml). No major intra-operative complications have been encountered. Two cases (5.5%) have been converted because of local advancement (one case) and bleeding with unavailability of vessel sealing device at that time (one case). The median time for passing flatus after surgery was 36 h (12–72 h). The median hospital stay was 4.8 days (4–7 days). The peri-operative period passed without events. Pathologic outcome revealed that the median number of retrieved lymph nodes was 14 (range 9–23 lymph node) and all cases had free surgical margin. Conclusion: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.

Background: Laparoscopic colectomy has been shown to have significant short- and long-term benefits compared to open approach. The incorporation of laparoscopy in developing countries is challenging, due to the high costs of equipment and lack of expertise. The aim of this study was to evaluate the safety and feasibility of laparoscopic colorectal surgery for cancer that could be performed in developing countries under different circumstances in developed countries. Methods: Thirty-seven patients (23 males and 14 females) with colorectal cancer with a median age of 46 years (39–72) have been enrolled for laparoscopic colo-rectal surgery in a tertiary center in Egypt (South Egypt Cancer Institute) with the trend of reuse of some disposable laparoscopic instruments. Results: The median operative time was 130 min (95–195 min). The median estimated blood loss was 70 ml (30–90 ml). No major intra-operative complications have been encountered. Two cases (5.5%) have been converted because of local advancement (one case) and bleeding with unavailability of vessel sealing device at that time (one case). The median time for passing flatus after surgery was 36 h (12–72 h). The median hospital stay was 4.8 days (4–7 days). The peri-operative period passed without events. Pathologic outcome revealed that the median number of retrieved lymph nodes was 14 (range 9–23 lymph node) and all cases had free surgical margin. Conclusion: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.

Background: Laparoscopic colectomy has been shown to have significant short- and long-term benefits compared to open approach. The incorporation of laparoscopy in developing countries is challenging, due to the high costs of equipment and lack of expertise. The aim of this study was to evaluate the safety and feasibility of laparoscopic colorectal surgery for cancer that could be performed in developing countries under different circumstances in developed countries. Methods: Thirty-seven patients (23 males and 14 females) with colorectal cancer with a median age of 46 years (39–72) have been enrolled for laparoscopic colo-rectal surgery in a tertiary center in Egypt (South Egypt Cancer Institute) with the trend of reuse of some disposable laparoscopic instruments. Results: The median operative time was 130 min (95–195 min). The median estimated blood loss was 70 ml (30–90 ml). No major intra-operative complications have been encountered. Two cases (5.5%) have been converted because of local advancement (one case) and bleeding with unavailability of vessel sealing device at that time (one case). The median time for passing flatus after surgery was 36 h (12–72 h). The median hospital stay was 4.8 days (4–7 days). The peri-operative period passed without events. Pathologic outcome revealed that the median number of retrieved lymph nodes was 14 (range 9–23 lymph node) and all cases had free surgical margin. Conclusion: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.