Egyptian Journal of Surgery最新文献

{"title":"Isolated Roux-en-Y loop for pancreatic and gastro-biliary anastomoses versus conventional single-loop jejunal reconstruction after pancreaticoduodenectomy: a randomized comparative study","authors":"A. Fawzy, M. Balbaa, A. Elgammal, Mohammed A. Elbalshy, A. Gaber","doi":"10.4103/ejs.ejs_272_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_272_22","url":null,"abstract":"Background Pancreaticoduodenectomy (PD) is the definitive treatment in managing malignant and selected benign pancreatic and periampullary lesions. Pancreatico-enteric anastomosis is the ‘Achilles heel’ of reconstruction. Postoperative pancreatic fistula (POPF) paves the way for other complications and increases their severity. Anastomotic diversion into two isolated loops may contribute to decrease these problems. Patients and methods Fifty-two patients underwent PD for different pancreatic and periampullary lesions. The patients were divided randomly into two groups: 26 patients each. Isolated pancreatic anastomosis was done using Roux-en-Y loop reconstruction for pancreatic and gastro-biliary anastomoses were performed in one group, while conventional single jejunal loop was used for pancreatic, biliary, and gastric anastomoses. Preoperative, operative, and postoperative data were recorded and analyzed. Results There was no significant statistical difference between study groups in demographic data, comorbidities, clinical presentation, or type and site of pathologies. There was a significant difference favoring the isolated loop group as regards the hospital stay, time for drain removal, and major complication rates (P=0.007, 0.020, and 0.035, respectively). POPF, biliary leakage, steatorrhea, postoperative hemorrhage, need for reoperation, delayed gastric emptying, intra-abdominal sepsis, time to resume oral fluids, and the postoperative mortality or morbidity within the first 30 postoperative days were reduced in the isolated loop group but the difference did not reach a statistical significance. While postoperative wound infection and pulmonary complications were less in the conventional groups but also the difference did not reach a statistically significant value. Conclusion Isolated Roux-en-Y loop pancreaticojejunostomy after PD is safe and easy. There was a reduction of POPF and biliary leak that did not reach a significant value, however, it decreased its related complications with significant reduction of hospital stay, time for drain removal, and major complication rates.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1585 - 1595"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44887419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular aortic aneurysm repair with iliac branched device for treatment of aortoiliac aneurysms: short-term results","authors":"Hisham Desoky, Samir A. Zied, Mahmoud Nasser","doi":"10.4103/ejs.ejs_278_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_278_22","url":null,"abstract":"Background Abdominal aortic aneurysm (AAA) is a life-threatening disease, which may be discovered incidentally or upon its rupture. The endovascular AAA repair ‎(EVAR) has become the treatment of choice owing ‎to its minimal invasiveness. It is challenged by the presence of concomitant common iliac artery aneurysms as there is no proper sealing zone distal to the aneurysm. ‎Currently, advances in ‎graft technology yielded the iliac branch devices (IBDs) to be the solution to keep the internal iliac artery blood flow and preclude pelvic ischemic complications.‎ Aim This study aimed to present our experience and the short-term outcome of using IBD during AAA repair. Patients and methods This is a retrospective study that included 20 patients with aortoiliac aneurysms indicating interventions. After proper selection, patients were treated with EVAR with Cook Zenith IBD implantation. Results Technical and clinical success was achieved in all ‎cases. Primary patency was 100% at 1 year. No IBD-related complications were encountered. Type II endoleak ‎was present in two cases with stable course and stationary sac size ‎not requiring intervention. Conclusion The short-term patient follow-up in this study highlighted that when patients are ‎properly selected and precise technical manipulation is secured, EVAR-IBD is a ‎feasible, effective, and safe treatment ‎of choice for patients with AAA and common iliac artery ‎aneurysms. It offered substantial clinical and ‎technical success, and iliac patency, with ‎no procedure-related significant morbidity or ‎mortality.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1605 - 1610"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44981328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neutrophil-to-lymphocyte ratio in the prediction of early postoperative complications after surgery for intestinal obstruction","authors":"Abd El Raof Mohamed, M. Elghandour, G. Nashed, Ahmed Abdulaziz","doi":"10.4103/ejs.ejs_312_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_312_22","url":null,"abstract":"Background Gastrointestinal surgery is associated with significant risk of postoperative complications, reaching up to 50% of cases especially in major operations. These complications have their detrimental effects not only on the patients, physically and psychologically, but also they induce a significant increase in costs, a timely concern while healthcare expenditures need to be controlled. Aim This study was designed to determine the value of a simple noninvasive parameter − the neutrophil-to-lymphocyte ratio (NLR) − in the first day postoperative in the prediction of early postoperative complications following intestinal obstruction surgery. Patients and methods This study includes 170 consecutive patients complaining of intestinal obstruction due to different primary causes and not having a previous abdominal surgery. The number of the male patients in the study is 97 (57.1%) patients, while the females are 73 (42.9%). The age of the patients was in the range in between 16 and 70 years with a mean age of 53.16±2.57 years. Results The NLR value in the preoperative investigation ranges between 2 and 25 with an average value of 6.71±8.7. The NLR that was done in the first postoperative day ranges between 0.6 and 31.3 with an average value of 6.77±4.75. Although the NLR increases postoperatively, it was found that there is insignificant difference between the NLR before and after 24 h postoperatively. The NLR of the complicated patients ranged between 1.61 and 31.3 with an average value of 8.65±4.83, while that of noncomplicated cases have a range of 0.6–7.63 with an average of 3.985±1.47. The difference of the mean of NLR in first postoperative day between complicated and noncomplicated cases is highly significant. Receiver-operating characteristic curve analysis of NLR suggested that a cutoff value of 5.01 was the optimal value for predicting complications, with an area under the curve of 0.873. This cutoff point produced a sensitivity of 84.61% (95% confidence interval=0.7545–0.9133) and a specificity of 78.37% (95% confidence interval=0.6728–0.8711). The overall model quality is good as it is equal to 0.82. Conclusion NLR is a good, cheap, and easily available investigation that can predict postoperative early complication after operation for intestinal obstruction. It has good sensitivity and specificity in the prediction of early postoperative complications. Further studies that compare other cheap and easily available biomarkers with NLR in predicting postoperative complications are required.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1810 - 1815"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47149641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between pile plication technique and open hemorrhoidectomy in the management of noncomplicated second-degree and third-degree hemorrhoids","authors":"Ehab Abd El-Wahab, Ahmad Osman, M. Helmy","doi":"10.4103/ejs.ejs_258_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_258_22","url":null,"abstract":"Background Hemorrhoids are a common clinical condition affecting half of the population. It is estimated that 58% of people aged over 40 years have the disease in the USA. Milligan–Morgan hemorrhoidectomy is considered the gold standard for the surgical treatment of hemorrhoids. However, these procedures are associated with significant postoperative complications, including pain, sepsis, anal stenosis, bleeding, and incontinence. The pile plication technique is based on the fact that the hemorrhoidal vessels have a constant anatomical location. They penetrate the hemorrhoid at its base. Sutures applied at the base of the hemorrhoid cushion can diminish the blood flow to the hemorrhoidal plexus and control the prolapse as well. Patients and methods This randomized prospective study was conducted at Ain Shams University hospitals from January 2020 to December 2021 and included 110 patients who presented with third-degree noncomplicated piles and second-degree noncomplicated piles after the failure of medical treatment. They were randomly allocated into two groups (group A: open hemorrhoidectomy and group B: plication group), and each group included 55 patients. In the plication group, the pile masses were plicated continuously just below the anorectal till the dentate line occluded the superior hemorrhoidal vessel. Postoperative follow-up visits were scheduled on the first and second week postoperatively, and then after 1, 3, and 6 months from the initial procedure. Careful postoperative assessment was carried out, including resolved clinical symptoms, bowel habits, complications, or recurrences, which were recorded and carefully assessed. Results Patients’ age ranged from 35 to 54 years. Overall, 82% of patients presented with third-degree noncomplicated piles, and the remainder presented with second-degree noncomplicated piles. There was no statistically significant difference regarding patients’ mean age, sex, and piles degree between both groups. The mean operative time for the open group was 41.85 min and for the plication group 29.4 min, with a clear statistical significance. There was a statistically significant difference regarding the mean hospital stay, postoperative visual analog scale score, and mean time to return to work, in favor of the plication group. There was no statistically significant difference regarding the early and late postoperative complications, except for urine retention, which was much higher among the open group. Conclusion Pile plication technique is a minimally invasive procedure, which is effective in controlling hemorrhoidal symptoms, thus improving the quality of life by preserving the rectal arterial flow and considerably avoiding postoperative complications in comparison with open hemorrhoidectomy.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1563 - 1571"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44798753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right common iliac artery pseudoaneurysm with arteriovenous fistula: a case report","authors":"Nabeel Almadwahi, A. Saleh, F. Alfahd","doi":"10.4103/ejs.ejs_240_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_240_22","url":null,"abstract":"Background Although exceedingly uncommon, iliac artery pseudoaneurysms might complicate trauma, surgical, or interventional operations. Aim We are presenting this case to emphasize how vital it is to rule out vascular lesions as a possible diagnosis when patients arrive with mass or pressure feelings in various body areas. Result Report of a 29-year-old man with a painful right lower abdomen pulsatile mass that turned out to be a pseudo aneurysm originating from the right common iliac artery, which was verified by contrast-enhanced CT and CT angiography. A large aneurysm connected to a fistula between the right common iliac artery and vein was discovered after open surgery where aneurysmal sac excised and PTFE interposition graft was used to reconstruct the artery and on follow up patient pass smoothly. Conclusion Serious implications might follow from misdiagnosing these lesions as soft tissue tumors or abscesses so it is paramount to put arterial lesion in differential diagnosis.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1861 - 1863"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43887890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ovarian vein embolization in pelvic congestion syndrome: technique and midterm results","authors":"Hossam Elmahdy, Hussien Khairy, Amr Elreheem, Qaysar Awad, Samir Zeid, Amr Elbahaey","doi":"10.4103/ejs.ejs_241_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_241_22","url":null,"abstract":"Background Pelvic congestion syndrome is defined as intermittent or constant pain that persists for at least 3–6 months, is localized in the abdomen or pelvis, is not associated with pregnancy, is not limited to any period of menstrual cycle or intercourse, and is severe enough to cause functional disability or require treatment. This condition has been recognized as a potential cause of chronic pelvic pain (CPP) in women of childbearing age. The aim of this study was to detect the efficacy of embolization of ovarian veins by assessing the adequacy of closure of incompetent pelvic veins and abolishment of venous reflux in the addressed ovarian veins. Patients and methods A single-center prospective study was conducted on 14 women of childbearing age complaining of CPP associated with dysmenorrhea, dyspareunia, andor vulvar varicosity, lower limb pain. All patients underwent lower limb venous duplex as well as pelvis duplex to assess the presence of dilated and refluxing ovarian vein more than 6 mm in diameter. Gynecological causes of pelvic pain were excluded; all patients underwent venography in an angiosuite to confirm the diagnosis of dilated ovarian vein and presence of parametrial varicosities. Embolization of ovarian vein and associated pelvic veins was done using foam sclerotherapy with polidocanol and coiling of the ovarian vein with coils ranging from 8 to 12 mm in diameter. Results In our study, there was a statistically significant improvement in symptoms in our patients after coiling during the follow-up compared with before coiling, including CPP (P=0.002), lower limb pain (P=0.003), dyspareunia (P=0.003), and dysmenorrhea (P=0.002). Conclusion The embolization of ovarian vein is feasible, safe, and effective with high rates of success and clinical improvement in the treatment of pelvic congestion syndrome.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1507 - 1514"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41423245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stone density and skin-to-stone distance in noncontrast computed tomography as prognostic indicators for the success of extracorporeal shock wave lithotripsy in ureteral stone disease","authors":"M. Elmoazen, A. Elshafei, H. Abdallah, Samir Elghobashy, Mohamed Alfateh Badawy, Ahmed Emam, M. Gamal, H. Gad, A. Tawfeek","doi":"10.4103/ejs.ejs_285_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_285_22","url":null,"abstract":"Background Urinary stones are becoming more common, which is a major health issue. Ureteral stones that originate in the kidney and then descend the ureter are a frequent cause of renal colic. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy are the two main procedures used to treat symptomatic ureteral calculi. Aim The aim of the present study was to assess the prognostic significance of skin-to-stone distance (SSD) and mean stone attenuation value in patients who may be candidates for ESWL for ureteral stones. Patients and methods This retrospective cohort observational study evaluated the prognostic value of SSD, mean attenuation value, and BMI in 66 patients with upper ureteral calculi who underwent ESWL. After a maximum of two sessions, if no stone particles were discovered, we categorized patients as stone free. Age, sex, SSD, maximum stone length, and stone Hounsfield units were examined in univariate and multivariate regression analyses. Results We found that factors including obesity (BMI >30.41), high stone density (Hounsfield units >935), and SSD more than 10 cm limited the effectiveness of therapy. On the contrary, higher shock levels (>2500 shocks each session) and shock intensities (>17 kV) were reliable indicators of treatment success. Conclusion We proposed a thorough analysis of the parameters prior to therapy to choose the best treatment option for each patient. It was found that a patient and stone feature before ESWL evaluation can predict the outcome of ureteric stone therapy. It was found that using these criteria can improve patient selection for ESWL and consequently ESWL effectiveness.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1618 - 1629"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43101098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective comparative study on appendectomy for complicated acute appendicitis via open versus laparoscopic approach","authors":"Basem H. Abd-El El Shayeb, Maha Zakaria, M. Matar, Dina Hany","doi":"10.4103/ejs.ejs_291_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_291_22","url":null,"abstract":"Introduction One of the most common causes of lower abdominal pain encountered in the emergency room is acute appendicitis. It is the most common cause of acute abdomen in young patients. Complicated appendicitis includes perforated, gangrenous appendicitis, peri-appendicular mass, or abscess. Appendectomy for acute appendicitis is the standard treatment. Objectives The aim of this study was to compare open and laparoscopic appendectomy in the management of complicated acute appendicitis with respect to operative outcomes, including operative time and intraoperative complications, and postoperative outcomes, including start of oral intake, length of hospital stay, return to normal activities, and early postoperative complications as wound infection, and postoperative sepsis and ileus. Patients and methods This is a prospective randomized controlled clinical trial performed from June 2021 to June 2022. The study included 50 patients with complicated acute appendicitis. Patients were divided into two groups according to the type of the procedure done for appendectomy whether open or laparoscopic. Each group included 25 patients. Randomization was done using the closed envelope method. Results The mean operative time was statistically higher in the laparoscopic group, with a P value less than 0.001. There was no statistically significant difference between both groups regarding start of oral feeding and hospital stay. The mean duration of return to normal activity and the rate of wound infection were statistically higher in the open group. Conclusion Laparoscopic appendectomy is a safe and feasible surgical option for complicated acute appendicitis. Despite having more operative time, it has less rate of postoperative complications with early return to normal activity.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1643 - 1648"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47531870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of early surgical intervention on the outcome of cases with penetrating cardiac trauma","authors":"Ayman M. Shaalan, A. AbdelAzim","doi":"10.4103/ejs.ejs_237_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_237_22","url":null,"abstract":"Background Early management of penetrating cardiac injury is crucial to improve the outcome of trauma cases. Aim To assess the effect of early surgical intervention in cases with penetrating cardiac injury on patients’ outcomes. Methods This observational study reviewed the hospital files of cases that presented to the emergency departments of two tertiary centers following chest trauma. The patients were categorized according to the time duration from presentation to surgical intervention into early intervention (within less than 30 min) and late intervention groups (after more than 30 min). Results The study included 29 cases. Early intervention occurred in 18 cases, whereas 11 cases had the intervention after 30 min. Early intervention was significantly associated with lowering the median ICU stay (P=0.009), the median duration of mechanical ventilation (P=0.008), and the rate of complications (P=0.048) as well as an excellent rating of satisfaction (P<0.001). On multivariate analysis, early intervention was associated significantly with lower ICU stay [odds ratio (OR): 0.063, 95% confidence interval (CI): 0.007–0.546, P=0.012] and hospital stays (OR: 0.184, 95% CI: 0.040–0.844, P=0.029) but did not significantly reduce the probability of complications (OR: 0.097, 95% CI: 0.009–1.022, P=0.052). Conclusions Early surgical intervention positively affects the patient’s outcome after penetrating cardiac injuries. It reduces ICU and hospital stays and may decrease the rate of complications. Every effort should be directed toward reducing the time lag from emergency department to the operating theater.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1479 - 1490"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43164480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between laparoscopic Heller’s cardiomyotomy and peroral endoscopic myotomy in treatment of esophageal achalasia","authors":"A. Saber, Ayman S. Helmy, Shaimaa El Kholy, Mohamed Azzam","doi":"10.4103/ejs.ejs_246_22","DOIUrl":"https://doi.org/10.4103/ejs.ejs_246_22","url":null,"abstract":"Background Achalasia is a motility disorder characterized by the lower esophageal sphincter’s inability to relax in absence of peristalsis. It causes dysphagia, undigested food regurgitation, chest pain, weight loss, and respiratory symptoms such as nocturnal cough, recurrent aspiration, and pneumonia. Patients and methods This study included 46 patients who were admitted with symptoms of achalasia in Cairo University hospitals. Laparoscopic Heller’s cardiomyotomy (LHM) was performed for 23 patients and peroral endoscopic myotomy (POEM) was done for other 23 patients. Clinical assessment using the Eckardt score was done for all patients preoperatively and 3 months postoperatively. Results The operative time ranged from 90 to 160 min in LHM patients (group 1) (mean, 125.7 min), whereas it ranged from 75 to 180 min in POEM patients (group 2) (mean, 123.8 min). BMI postoperatively ranged from 25.2 to 30.9 kg/m2 (mean, 26.9 kg/m2) in group 1, whereas in group 2, it ranged from 16.02 to 43.36 kg/m2 (mean, 26.8 kg/m2). Conclusion There was no significant difference between LHM and POEM in terms of their resolution or improvement of symptoms of achalasia in our research, but there was a significant difference regarding gastroesophageal reflux symptoms postoperatively between both groups, in which gastroesophageal reflux symptoms postoperatively occurred with POEM and did not occur with LHM.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"41 1","pages":"1515 - 1523"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43183496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}