Background:Laparoscopic surgery with a small laparotomy reportedly has several advantages over conventional open surgery, including less invasiveness, less pain, earlier recovery,and bettercosmoses. Theaimofthis study was tocomparetechnicalfeasibilityand early clinical outcomes of laparoscopic-assis'cd and open radical gastrectomy for gastric cancer. Patients and methods:ln our prospective study, patients with distal gastric cancer were divided the patients in two groups (a) patients underwent radical gastrectomy by LADG (21 patients)and(b) aDG (21 patients).Forthepostoperativepathologicresults,the tumor-nodalmetastasis (1NM) stage, grade of tumor differentiation, distal and proximal margins, the number of harvested lymph nodes were evaluated.Staging was done according to the 7th edition of the UICC tumor, node, and metastasis (TNM) classification. 0 Iand D2 lymphadenectomy with curative RO intention was attempted in all cases.Operative mortality and morbidity were assessed. Results: The time to initiate oral intake, and postoperative hospital stay were significantly shorter in the LADG group than ill the ODG group (P 0.05).There no significant difference between the operative time in the LADG group and the aDO group (P = 0.6), whereas blood loss and blood infusion frequency were significantly lower (P O.OOOt) in the LADG group in comparison to ODG group. Conclusion:Laparoscopic-assisted distal gastrectomy for distal gastric cancer is a safe and feasible technique alternative to open gastrectomy, with at least similar short term oncologic results. However, laparoscopic gastric surgery is in need to Adequate training and technical support especially in D2 lymphadenectomy.

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.

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.