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Abstract: Background: Many options are available for treatment sacrococcygeal pilonidal sinus disease either surgical or medical, but surgery is preferred. There are many techniques for surgical treatment but there is controversy about the best technique. Until now there is no single procedure is superior in all aspects. The aim of this study was to evaluate modified Bascom Clift lift procedure in management of. Patients and methods: From April 2014 to July 2018, 150 patients with pilonidal sinus were treated with Clift lift procedure and followed. Data collected tabulated and analyzed included complications, recurrence, post-operative hospital stay, days-off work, postoperative aesthetic appearance and patient's satisfactions. Results: There were 150 patients, 129 male and 21 females with M:F ratio. Their ages ranges from 16 to 45 year, with mean age 22.55± 8.5 year. Fifteen patients (10%) had previous operation for pilonidal sinus (recurrent). After operation all patient were mobilized at first day, mean postoperative pain VAS score were about 2(1-3) and discharged from hospital at 2nd day and were returned to daily activities after mean 7 day (6-12 days), return to work at mean (12.5) days with good healing within 10 days, postoperative wound infection had occurred only in three patients (2%). Patients satisfaction score were very good. No recurrence was observed during follow up period. Conclusion: Modified Bascom natal cleft lift is associated with good outcome, it is simple procedure and easy to learn, with early mobilization, short hospital stay early return to daily activities and work, and good patients satisfaction and to somewhat accepted post-operative scar. More studies with larger group of patients are needed especially in recurrent cases to come to consensus.

Abstract: Background: Trauma is one of the first 10 leading causes of death in the first 4 decades of life. Approximately 10-15% of pediatric trauma patients suffer abdominal injuries, with blunt injuries to the spleen and liver being the most frequent. Trauma is the leading cause of death and disability in children, and truncal trauma is the second most frequent cause of death among children, after head injury. Thromboembolic complications are common in traumatized patient and the affection of spleen in the trauma or complete loss of it by total splenectomy rise the risk especially in the first 72 hours. Purpose of the study: To evaluate the effect of partial versus total splenectomy on hypercoagualable state of traumatized children. Methods: In a prospective, nonrandomized, single-center study cross sectional study, we recruited 20 patients who had trauma recently. Half of our patients` population underwent a partial splenectomy and the rest of them had total splenectomy. Results: There is no increase after partial splenectomy nor total splenectomy in first 3 days in platelets count. In both groups, the patients showed normal prothrombin time and concentration with normal INR level and normal fibrinogen level. Conclusion: There is no significant effect on hypercoagualable state between partial and total splenectomy in the first 3 days postoperative in traumatized children.

Abstract: Background: Trauma is one of the first 10 leading causes of death in the first 4 decades of life. Approximately 10-15% of pediatric trauma patients suffer abdominal injuries, with blunt injuries to the spleen and liver being the most frequent. Trauma is the leading cause of death and disability in children, and truncal trauma is the second most frequent cause of death among children, after head injury. Thromboembolic complications are common in traumatized patient and the affection of spleen in the trauma or complete loss of it by total splenectomy rise the risk especially in the first 72 hours. Purpose of the study: To evaluate the effect of partial versus total splenectomy on hypercoagualable state of traumatized children. Methods: In a prospective, nonrandomized, single-center study cross sectional study, we recruited 20 patients who had trauma recently. Half of our patients` population underwent a partial splenectomy and the rest of them had total splenectomy. Results: There is no increase after partial splenectomy nor total splenectomy in first 3 days in platelets count. In both groups, the patients showed normal prothrombin time and concentration with normal INR level and normal fibrinogen level. Conclusion: There is no significant effect on hypercoagualable state between partial and total splenectomy in the first 3 days postoperative in traumatized children.

Abstract: Background: Trauma is one of the first 10 leading causes of death in the first 4 decades of life. Approximately 10-15% of pediatric trauma patients suffer abdominal injuries, with blunt injuries to the spleen and liver being the most frequent. Trauma is the leading cause of death and disability in children, and truncal trauma is the second most frequent cause of death among children, after head injury. Thromboembolic complications are common in traumatized patient and the affection of spleen in the trauma or complete loss of it by total splenectomy rise the risk especially in the first 72 hours. Purpose of the study: To evaluate the effect of partial versus total splenectomy on hypercoagualable state of traumatized children. Methods: In a prospective, nonrandomized, single-center study cross sectional study, we recruited 20 patients who had trauma recently. Half of our patients` population underwent a partial splenectomy and the rest of them had total splenectomy. Results: There is no increase after partial splenectomy nor total splenectomy in first 3 days in platelets count. In both groups, the patients showed normal prothrombin time and concentration with normal INR level and normal fibrinogen level. Conclusion: There is no significant effect on hypercoagualable state between partial and total splenectomy in the first 3 days postoperative in traumatized children.

Abstract Background: Achalasia is a rare but troublesome disease with multiple treatment options. Currently, no treatment option can change the underlying pathology of the disease. All available options only palliate symptoms to varying degrees and for varying durations. They include medications, endoscopic balloon dilatation, Botulinum toxin injection and surgery; open and laparoscopic. Objectives: Prospective study to assess the results of laparoscopic cardiomyotomy with Dor fundoplication for treatment of esophageal achalasia. Patients and Methods: The study included 19 consecutive idiopathic achalasia patients who were admitted to the Surgery Departments in Assuit and South Valley University Hospitals, from April, 1st 2014 to March, 31st 2017. Laparoscopic cardiomyotomy with Dor fundoplication was done in all patients. Mean follow up was 19 (12-30) months. Follow up included changes in Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, patient weight and satisfaction after surgery, and intra- and post-operative complications. Results: This study included 11 females and 8 males. Mean age was 44.5 years (range, 18 - 75 years). Mean operative time was 145.5± 36.2 (range 100-210) minutes. Mean hospital stay was 3.5 (range 2- 6) days. Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, assessed according to Eckardt scores, improved significantly in 95%, 89%, 70%, 95%, and 75% of patients respectively. P-values were 0.001, 0.003, 0.01, 0.01 and 0.01, respectively. Body weight increased in 90% of patients and 80% of patients claimed satisfaction. Mucosal perforation at the cardia occurred in 2 patients (10%); it was repaired and tested for leakage at the same time without subsequent morbidity. Repeated postprandial vomiting occurred in 5 patients (25%). No postoperative leakage or mortalities occurred. Conclusions: Laparoscopic cardiomyotomy with anterior Dor fundoplication for achalasia is feasible, safe and effective, with significant and durable relief of dysphagia and overall patient symptoms.

Abstract Background: Achalasia is a rare but troublesome disease with multiple treatment options. Currently, no treatment option can change the underlying pathology of the disease. All available options only palliate symptoms to varying degrees and for varying durations. They include medications, endoscopic balloon dilatation, Botulinum toxin injection and surgery; open and laparoscopic. Objectives: Prospective study to assess the results of laparoscopic cardiomyotomy with Dor fundoplication for treatment of esophageal achalasia. Patients and Methods: The study included 19 consecutive idiopathic achalasia patients who were admitted to the Surgery Departments in Assuit and South Valley University Hospitals, from April, 1st 2014 to March, 31st 2017. Laparoscopic cardiomyotomy with Dor fundoplication was done in all patients. Mean follow up was 19 (12-30) months. Follow up included changes in Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, patient weight and satisfaction after surgery, and intra- and post-operative complications. Results: This study included 11 females and 8 males. Mean age was 44.5 years (range, 18 - 75 years). Mean operative time was 145.5± 36.2 (range 100-210) minutes. Mean hospital stay was 3.5 (range 2- 6) days. Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, assessed according to Eckardt scores, improved significantly in 95%, 89%, 70%, 95%, and 75% of patients respectively. P-values were 0.001, 0.003, 0.01, 0.01 and 0.01, respectively. Body weight increased in 90% of patients and 80% of patients claimed satisfaction. Mucosal perforation at the cardia occurred in 2 patients (10%); it was repaired and tested for leakage at the same time without subsequent morbidity. Repeated postprandial vomiting occurred in 5 patients (25%). No postoperative leakage or mortalities occurred. Conclusions: Laparoscopic cardiomyotomy with anterior Dor fundoplication for achalasia is feasible, safe and effective, with significant and durable relief of dysphagia and overall patient symptoms.

Abstract Background: Achalasia is a rare but troublesome disease with multiple treatment options. Currently, no treatment option can change the underlying pathology of the disease. All available options only palliate symptoms to varying degrees and for varying durations. They include medications, endoscopic balloon dilatation, Botulinum toxin injection and surgery; open and laparoscopic. Objectives: Prospective study to assess the results of laparoscopic cardiomyotomy with Dor fundoplication for treatment of esophageal achalasia. Patients and Methods: The study included 19 consecutive idiopathic achalasia patients who were admitted to the Surgery Departments in Assuit and South Valley University Hospitals, from April, 1st 2014 to March, 31st 2017. Laparoscopic cardiomyotomy with Dor fundoplication was done in all patients. Mean follow up was 19 (12-30) months. Follow up included changes in Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, patient weight and satisfaction after surgery, and intra- and post-operative complications. Results: This study included 11 females and 8 males. Mean age was 44.5 years (range, 18 - 75 years). Mean operative time was 145.5± 36.2 (range 100-210) minutes. Mean hospital stay was 3.5 (range 2- 6) days. Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, assessed according to Eckardt scores, improved significantly in 95%, 89%, 70%, 95%, and 75% of patients respectively. P-values were 0.001, 0.003, 0.01, 0.01 and 0.01, respectively. Body weight increased in 90% of patients and 80% of patients claimed satisfaction. Mucosal perforation at the cardia occurred in 2 patients (10%); it was repaired and tested for leakage at the same time without subsequent morbidity. Repeated postprandial vomiting occurred in 5 patients (25%). No postoperative leakage or mortalities occurred. Conclusions: Laparoscopic cardiomyotomy with anterior Dor fundoplication for achalasia is feasible, safe and effective, with significant and durable relief of dysphagia and overall patient symptoms.

Abstract Background: Achalasia is a rare but troublesome disease with multiple treatment options. Currently, no treatment option can change the underlying pathology of the disease. All available options only palliate symptoms to varying degrees and for varying durations. They include medications, endoscopic balloon dilatation, Botulinum toxin injection and surgery; open and laparoscopic. Objectives: Prospective study to assess the results of laparoscopic cardiomyotomy with Dor fundoplication for treatment of esophageal achalasia. Patients and Methods: The study included 19 consecutive idiopathic achalasia patients who were admitted to the Surgery Departments in Assuit and South Valley University Hospitals, from April, 1st 2014 to March, 31st 2017. Laparoscopic cardiomyotomy with Dor fundoplication was done in all patients. Mean follow up was 19 (12-30) months. Follow up included changes in Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, patient weight and satisfaction after surgery, and intra- and post-operative complications. Results: This study included 11 females and 8 males. Mean age was 44.5 years (range, 18 - 75 years). Mean operative time was 145.5± 36.2 (range 100-210) minutes. Mean hospital stay was 3.5 (range 2- 6) days. Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, assessed according to Eckardt scores, improved significantly in 95%, 89%, 70%, 95%, and 75% of patients respectively. P-values were 0.001, 0.003, 0.01, 0.01 and 0.01, respectively. Body weight increased in 90% of patients and 80% of patients claimed satisfaction. Mucosal perforation at the cardia occurred in 2 patients (10%); it was repaired and tested for leakage at the same time without subsequent morbidity. Repeated postprandial vomiting occurred in 5 patients (25%). No postoperative leakage or mortalities occurred. Conclusions: Laparoscopic cardiomyotomy with anterior Dor fundoplication for achalasia is feasible, safe and effective, with significant and durable relief of dysphagia and overall patient symptoms.

Abstract Background: Achalasia is a rare but troublesome disease with multiple treatment options. Currently, no treatment option can change the underlying pathology of the disease. All available options only palliate symptoms to varying degrees and for varying durations. They include medications, endoscopic balloon dilatation, Botulinum toxin injection and surgery; open and laparoscopic. Objectives: Prospective study to assess the results of laparoscopic cardiomyotomy with Dor fundoplication for treatment of esophageal achalasia. Patients and Methods: The study included 19 consecutive idiopathic achalasia patients who were admitted to the Surgery Departments in Assuit and South Valley University Hospitals, from April, 1st 2014 to March, 31st 2017. Laparoscopic cardiomyotomy with Dor fundoplication was done in all patients. Mean follow up was 19 (12-30) months. Follow up included changes in Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, patient weight and satisfaction after surgery, and intra- and post-operative complications. Results: This study included 11 females and 8 males. Mean age was 44.5 years (range, 18 - 75 years). Mean operative time was 145.5± 36.2 (range 100-210) minutes. Mean hospital stay was 3.5 (range 2- 6) days. Dysphagia, regurgitation, chest pain, heartburn, and chocking during sleep, assessed according to Eckardt scores, improved significantly in 95%, 89%, 70%, 95%, and 75% of patients respectively. P-values were 0.001, 0.003, 0.01, 0.01 and 0.01, respectively. Body weight increased in 90% of patients and 80% of patients claimed satisfaction. Mucosal perforation at the cardia occurred in 2 patients (10%); it was repaired and tested for leakage at the same time without subsequent morbidity. Repeated postprandial vomiting occurred in 5 patients (25%). No postoperative leakage or mortalities occurred. Conclusions: Laparoscopic cardiomyotomy with anterior Dor fundoplication for achalasia is feasible, safe and effective, with significant and durable relief of dysphagia and overall patient symptoms.