1

RESUME

PERSONAL DATA:-

1. NAME : Mohamed Farid.

2. DATE OF BIRTH : 24/9/1952.

3. PLACE OF BIRTH : Mansoura, Egypt.

4. SEX : Male.

5. MARITAL STATUS : Married and has three offspring.

6. NATIONALITY : Egyptian.

7. RELIGION : Moslem.

8. FOREIGN LANGUAGE : English.

9. PASSPORT NO : 02464

10. EMPLOYMENT : Professor of General and Colorectal

Surgery.

11. ADDRESS : Mansoura , Portsaid St. P.O. 324

12. TEL. : 050/2334900 Home .

: 050/2219403 Private Clinic.

: 050/2256606 Private Hospital.

13. FAX : 050/2219403

14. E-MAIL : mfshzk2005@yahoo.com

: mfshzk @hotmail.com

2

QUALIFICATION:

MBBCH ( very good with honour) Mansoura University , Egypt , 1976.

Master degree in General Surgery ( very good ) Mansoura University , Egypt

, 1981.

M.D. in general surgery , Mansoura University , Egypt , 1984.

EMPLOYMENT HISTORY:

House officer from March 1977- March 1978.

Resident in general surgery department at Mansoura University hospital,

Egypt from November 25,1978 to November 24, 1981.

Assistant lecturer in general surgery at Mansoura Faculty of Medicine from

November 25, 1981 to March 24, 1985.

Visiting consultant in Jeddah Medical Center, Saudi Arabia for 45 days

began in October 1985 and another 50 days began in March 1986.

Lecturer in general surgery at Mansoura Faculty of Medicine from March

25, 1985 to March 24, 1990.

Assistant professor in general surgery at Mansoura Faculty of Medicine

from March 25, 1990 to March 24, 1995.

Professor in general surgery from 1995 onwards.

Founder & chair of colorectal surgery unit Mansoura University from 1997

on word.

Member of The Board of Mansoura University Hospital from 1997-2001.

Director of Mansoura University Hospital (1999 - 2001).

Director of Mansoura University Hospital (2005-2006)

Director general of Mansoura University Hospitals December 2005-2008.

Chairman of General Surgical Department from 1/8/2009 -31-7-2012.

Member of the board of councelers for evaluation and promotion

of professorship in general surgery

3

MEMBRSHIP OF INTERNATIONAL SOCIETIES:

1. J.S.C.P. (Japan Society of Coloproctology) From 1993

2. A.S.C.R.S. (American Society of Colorectal Surgeons) from 1994

onwords.

3. European Association of Endoscopic Surgeons (E.A.E.S.) from

1994.

4. International Society of University of Colon & Rectal Surgeons

(I.S.U.C.R.S.) from 1995.

5. International Socieity of Surgery (I.S.S.\ S.I.C.). (National

Delegate from 1997-2006.

6. Italian Society of Coloproctogy from 1997.

7. Meditrranean Socitey of Coloproctology (Mscp) Vice President

from (1997-2001).

8. European Association of Coloproctology (E.A.C.P) 2002.

9. European Council of Coloproctology (E.C.C.P) 2002.

10. International Society of Laser Medicine and Surgery 1997.

11. Membership of American Biographical Institute, ABI.

12. Award: Great Mind of 21st Centaury from American

Biographical Institute 2004- 2005.

13. Award: Leading Health Professionals of The World 2005.

4

MEMBRSHIP OF NATIONAL SOCIETIES:

Member of The Board of Egyptian Society of Surgery by election from

1999-2006.

Assistant general secretary of Egyption Society of Surgeons from 2006-

2013.

…General secretary of Egyption Society of Surgeons from 2013 onward

Member of The Board of Panarab Association of Surgery from 1999

onword.

Vice president of The Egyptian Group of Colorectal Surgery 2001 –

2003.

President of Egyptian Group of Colorectal Surgery (2003-2007).

Honorary president of The Egyption Group of Colorectal Sergeons from

2007.

--Ass general secretary PANARAB ASSOCIATION OF SURGEONS 2014

onward

.>FOUNDER OF ERAS INDUBAI 2015

5

SCIENTIFIC ACTIVITIES:

Moderator of meeting titled (Stapler Update in Surgery) Mansoura

University Hospital 1996.

General secretary of 1st International Congress Of Surgery In Mansoura and

Portsaid Egypt April 1997.

National delegate of International Society of Surgery from 1997 onword.

Member of Organising Commitee of Mansoura Faculty of Medicine annual

meeting (1995-1996-1997-1998-1999).

Member of The Board of Egyptian Society of Surgery by election from 1999-

2006.

Assistant general secretary of Egyption Society of Surgeons from 2006

…General secretary of Egyption Society of Surgeons from 2013 onward

.

Member of The Board of Panarab Association of Surgery from 1999 onword.

Coordinator of Precongress Workshop in Colorectal Surgery in collaboration

with Cleavland Clinic Foundition Colorectal Surgery Department.

Alexandria 1999.

Coordinator of 1st Congress of Egyptian Group of Colorectal Surgeons in

Taba, Sina Egypt 1999 January.

Vice president of The Egyptian Group of Colorectal Surgery 2001 – 2003.

Vice president of The 4th and 5th Annual Congress of Egyptian Group of

Colorectal Surgery Sharm El-Shikh 2002 – 2003.

President of Egyptian Group of Colorectal Surgery (2003-2007).

Vice president of Mediterranean Society of Coloproctology during the years

1998 – 1999- 2000-2001.

Member of Organising Commitee of 2nd Congress of Egyptian Group of

Colorectal Surgery in Hurghada January 2000 and 2nd Congress in Sharm

El-Shikh April 2001.

Moderetor of Annual Meeting of Egyptian Group of Colorectal Surgeons in

Mansoura 2001& 2002.

6

Member of Scientific Committe of Egyptian Society of Surgeons, Annual

Congress Cairo (1999-2000-2001-2002-2003 – 2004- 2005-2006-2007 -

2008 ------2011).

Member of Scientific Committe of Egyptian Society of Surgeons, summer

meeting (Alexandria) (1999 – 2000 – 2001 – 2002 – 2003 – 2004 – 2005-

2006-2007-2008----- 2011) .

Member of The International Order of Merit. July 2006.

Editorial manager online submission and peer reviewer for Techniques in

Coloproctology Journal from January.2007.

Honorary president of The Egyption Group of Colorectal Sergeons from

2007.

…General secretary of Egyption Society of Surgeons annual conference

from 2012- 2013 onward

7

TRAINING RECEIVED:

From 26th November 1990 to 18th January 1991 at The General Hospital ,

Queen Elizabith and The Children’s Hospital in Birmingham U.K – with

Professor "Alexander Williams – Mr. D Kumar – Mr. Buick- Mr. Durricot,

and Mr. Keighly" in the following training program:

- Attendance Clinics, Operating Sessions and Morbidity Conferences in

Different Lower Gastrointestinal Procedures with Prof. "Alexander

Williams" professor of Gastrointestinal Surgery in The General Hospital.

- Training in Surgical Procedures of Anal Incontinence and Pelvic Floor

Repair at the: Queen Elizabeth Hospital with "Mr. Kumar" consultant

surgeon.

- Training in Pediatric Endoscopic and Gastrointestinal Procedures with

"Mr. Buick" Consultant Pediatric Surgeon at The Children’s Hospital.

- Training in Laparoscopic Cholecystectomy with Mr. Durricott Consultant

Surgeon at The General Hospital.

Training in Laparoscpic Surgery: Gall Bladder, Colon, Hernia Varicocele

with "Dr. Goerge Frezli" at Staten Island University Hospital N.Y.Usa

(1993).

Training in Colorectal Surgery in Takano Colorectal Center and

Kummamoto University with professor "Mas. Takno" Japan (1993).

Training workshop in Laparoscopic Colorectal Surgery and Transanal

Endoscopic Microsurgery (TEM): Torino Italy 11-14 September 1996.

Training in Placement of Lap. Band Adjustable Gastric Banding: System in

workshop collaborated by King Faisal University Jeddah and Menoufya

University , Benha University and Vetranean Faculty Cairo University,

May 20-22/1997.

8

Two – day Workshop Principles of Surgical Research from Research

Methodology to writimg for publication, Military Medical Acadamy , May

2002.

One-Day Workshop "Surgical Presentation Skills" from writing the

abstract to its presentation in the Annual Meeting of Egyption Society of

Surgeons ,September 2002 & 2003.

9

NATIONAL CONFERENCES ATTENDED

1. Mansoura Faculty of Medicine Annual Meeting 1992 [Oration ]

2. 1st Inauguration Meeting of Gastrointestinal Motility Cairo 1993.

3. Mansoura Faculty of Medicine Annual Meeting 1993

4. Conference on Anal Incontinence December , 1993 Cairo.

5. Mansoura Pediatrics Annual Meeting 1994.[Oration ].

6. 12th Conference of Egyptian Society of Hepatology Cairo ,1994.

7. Mansoura Faculty of Medicine Annual Meeting 1994 [Oration ].

8. 12th Annual Conference of the Egyptian Group of Colon & Rectal

Surgeons. Sharm-Elshekh , 23-26-2010 , Honoray Chairman of the

conference .

9. Surgical Principles of Anal Incontinence & Workshop and Round

Table Disscussion of the 2nd Conference of Egyptian Group of

Gastrointestinal Motility May,1995 Mansoura [Oration ].

10. Mansoura Faculty of Medicine Annual Meeting 1995.

11. Egyptian Society of Surgeons Summer Meeting Alexandria 1995.

[Oration].

12. Egyptian Society of Surgeons Summer Meeting Alexandria 1996.

[Oration].

13. Mansoura Faculty of Medicine Annual Meeting 1996.

14. Mansoura Faculty of Medicine Annual Meeting 1997 .

15. The Second International Meeting for Surgery, Mansoura April 1997

16 . Egyptian Society of Surgeons Summer Meeting Alexandria 1997.

17. Egyptian Society of Surgeons Summer Meeting Alexandria 1998.

18. Mansoura Faculty of Medicine Annual Meeting 1998

19. Mansoura Faculty of Medicine Annual Meeting 1999

20. 17th Summer Meeting of The Egyptian Socity of Surgeons in

collaboration with the 9th Congress of The Pan Arab Association of

Surgeons , Alex. September 1999. [Oration ].

21. Symposium on Cancer Rectum Update in Menofya University. Egypt

1999 [ Chairman&Oration] .

11

22. Egyptian Society of Surgeons Summer Meeting Alexandria 1999

[Oration].

23. Egyption Group of Colorectal Surgeon Annual Conference Taba ,

1999 [Chairman & Oration] .

24. Egyption Group of Colorectal Surgeon Annual Conference Hurgada ,

2000 . [Chairman & Oration]

25. Egyption Group of Colorectal Surgeon Annual Conference Sharm-

Elshek , 2001 . [Chairman & Oration].

26. Functional Disorders of The Lower Bowel, Mansoura July, 2000

[Oration] .

27. 18th Annual Meeting Egyptian Society of Surgeons February, 2000 [

Moderator].

28. Egyptian Society of Surgeons Summer Meeting Alexandria 2000

[Oration].

29. Meeting on Colorectal Procedures Assuit University Egypt 2000 [

Chairman & Oration]

30. Surgery Depart. Conference in collaboration with Eg Colorectal Sur

Group Benha Univer 2001 [ Chairman& Oration]

31. Middle East Conference on 3 Dimension U.S. February 2001.

32. Conference of Dept. of Surgery (Benha University) in collaboration

with Egyptian Group Colorectal Surgery (2001) [Chairman& Oration] .

33. 3rd Annual Congress of Gastroenterology Port Said August 2001

[Speaker].

34. Gastro Intestinal Meeting Port Said Egypt 2001 [Chairman&

Oration] .

35. .Egyptian Society of Surgeons Summer Meeting Alexandria 2001

[Oration].

36. 19th Annual Meeting Egyptian Society of Surgeons February, 2001

[Oration]

37. Egyption Group of Colorectal Surgeon Annual Conference Sharm-

Elshekh , 2002 . [Chairman & Oration].

11

38. 19th Annual Meeting Egyptian Society of Surgeons February, 2002

[Oration]

39. Egyptian Society of Surgeons Summer Meeting.Alexandria 2002

[Oration].

40. Gastro Intestinal Meeting Port Said. Egypt 2002 [Chairman&

Oration] .

41. Conference on Perianal Crohn's Disease. Mansoura July, 2002.

42. 3rd International Mansoura Conference Surgery, Gastro-Entrology &

Oncology. Port Said, January 2003. [Chairman& Oration] . Moderator

International Meeting on Laparoscopic Surgery, Cairo October 2002.

43. Egyption Group of Colorectal Surgeon Annual Conference Sharm-

Elshekh , 2003 . [Chairman & Oration].

44. 3rd Annual Conference of The Domiatt Surgeons Augst 2003

Chairman Egyptian Society of Surgeons Summer Meeting. Alexandria

2003 [Oration].

45. 21st Summer Meeting of The ESS. Ethics in Alex. September 2003.

[Course Facilitator] .

46. Conference On Accreditation of Medical School 6th of October

University, Egypt , December 2003.

47. 20st Annual Meeting Egyptian Society of Surgeons February, 2003

[Oration].

48. Egyptian Society of Surgeons Summer Meeting. Alexandria 2004

[Oration].

49. 21th Annual Meeting Egyptian Society of Surgeons. February, 2004

[Oration].

50. Symposium on Minor Anal Surgery Materia Teaching Hospital.

Cairo Egypt 2004 [Chairman&Oration].

51. Egyption Group of Colorectal Surgeon Annual Conference Sharm-

Elshekh , 2004 . [Chairman & Oration]

12

52. 7th International Congress of Gastrointestinal & Hepatology, The

Egyption Hepato-Pancreato-Biliary Society

53. 4th Meeting of Italo-Egyptian Association for Digestive Diseases

54. 7th International Workshop of Therapeutic Endoscopy and

Laparoscopy. March ,2004 [Speaker] .

55. Conference on Gastrointestinal Malignancy, Mansoura, April 2004[

Chairman & Speaker] .

56. Colorectal Meeting Sharm-Elshekh 2004 [President Of The

Conference] IBD and Large Bowel Emergencies Symposium. Alex.

September 2004 [Speaker] .

57. 22nd Annual Summer Meeting of The Egyptian Society of Surgeons in

collaboration with Mastology Association of Northern and Southern

Mediterranean. Alex. September 2004 [Speaker] .Also

2005,2006,2007(chairman&oration).

58. Egyptian society of surgeons annual congress

2005,2006,2007(chairman&oration).

59. Egyption Group of Colorectal Surgeon Annual Conference Sharm-

Elshekh , 2005 . [Chairman & Oration].

60. Egyption Group of Colorectal Surgeon Annual Conference. Hurgada ,

2005 . [Chairman & Oration].

61. Quality Assurance and Accreditation of Medical Schools Mansoura,

April 2005 Chaiman.

62. Workshop & Scientific Meeting Gastrointestinal Surgery, Endoscopy

& Laparoscopy, Mansoura, April, 2005 Chaiman .

63. The First Scientific Meeting, Surgery Department, Sohag Faculty of

Medicine, in collaboration with The Egyptian Society of Surgeons and The

Egyptian Group of Colon and Rectal Surgeons. Anorectal Surgery

Updates, April 2005, President of Conference.

64. Updates in G.I.T. Surgery Conference, Port Said, August 2005

[Speaker].

65. Conference on G.I.T Disorders Domiate August 2005 [Speaker].

13

66. 3rd International Conference of The Egyptian Group of

Laparoendoscopic Surgeons in collaboration with The Arab Group for

Laparoscopic Surgery and The Mediterranean Middle East Association of

Laparoscopic Surgeons , December 2005.

67. The First Workshop, president the Scientific Workshop entitled "Basic

Principal of Infection Control" 17,18 May, 2006 Ramada Hotel Mansoura.

68. Colorectel Meeting Sharmelshekh 2005 [President of The

Conference].

69. 8th International Congress of Egyptian Society of Hepatology,

Gastrointology and Infectious Disease (Eshgid). Alexandria , September

2006.

70. 5th International Conference of The Egyptian Group of

Laparoendoscopic Surgeons in collaboration with The Arab Group for

Laparoscopic Surgery and The Mediterranean Middle East Association of

Laparoscopic Surgeons , November 2006.

71. Workshop in Minor and Surgery and The Egyptian Group of Colon

and Rectal Surgeons in collaboration with Kafr El Sheikh Medical

Syndicate. December 2006.

72. 5th International Conference of The Egyptian Group for The Study

of Gastrointestinal Motility - November 2006 – Sharm El Sheikh.

73. The Egyptian Hepato-Pancreato-Biliary Society. 10th International

Congress of Gastrointestinal Surgery&Hepatology. January 25-28, 2007.

President of Conference.

74. 25th Annual Meeting of The Egyptian Society of Surgeons in

collaboration with The Royal College of Surgeons of England-

February.2007-Cairo, Egypt.

75. 28th Annual and Scientific Congress of Alexandria Faculty of

Medicine. Hospital and Healthcare Management. Alexandria. Egypt. April

5-6, 2007.

14

76. Egyptian Society of Surgeons. 9th Annual Conference of The Egyptian

Group of Colon And Rectal Surgeons July 4-7,2007 Sharm El-Shiekh,

Egypt. (presdent of conference ) .

77. The Egyptian Group of Colon and Rectal Surgeons in collaboration

with Alexandria University. Workshop & Scientific Meeting titled: Total

Mesorectal Excision.18,19-22007. Chaiman.

78. 9th International Congress of The Egyptian Society of Hepatology,

Gastroenterology and Infectiuous Diseases. August 29-31 2007.

79. 7th National Congress of Mansoura Gastroenterology Center August

2007.

80. The 3rd Scientific Meeting , " Innovations in Surgery " Egyptian

Society of Surgeons in collaboration with IBN Sina National College for

Medical Studies and Al-Jedaani Group of Hospital , Jedda, Saudi Arabia,

September 10-11, 2007 .

81. 3rd Regional Congress of ESTIP (The Egyptian Society of Tropical

Medicine, Infectious and Parasitic Diseases). Taba, Egypt ,October 16th –

19th ,2007.

82. 10th Annual Conference of the Egyptian Group of Colon & Rectal

Surgeons. Savoy Sharm El-Sheikh , Egypt. June 25-28, 2008.Honery

president of conference.

83. Alexandia Gastroentrolgy club. February, 16 2008. oral prsentation

(obstructed defecation).

84. 26th annual conference of Egyption society of Surgeous Feb.20-

22/2008.Cairo. chairmen of cession (colorectal video cession) Oral

presentation titled conplications of pouch surgory.

85. Scientifice Conference in Insurance Hospital In Fayomin collabration

with Egyptian Society of Surgeons (Paper Presentation and Chairman )

july 2008.

86. Workshop & Scientific Meeting of the Egyptian Society of Surgeons

in collabration Surgery, Mansoura University , June, 2008 (Chairman &

Paper Presentation ).

15

87. 10th Annual Conference of The Egyptian Group of Colon and Rectal

Surgeons Shaem El- Sheikh June, 2009 Honary president (Chairman &

Paper Presentation ).

88. Egyption Group of Hepatobiliary and Pancreatic Congress . portsaid

Mayo 2008(Chairman).

89. 4th Workshop & Scientific Meeting in Mansoura University Faculty of

Medicine Gastroenterology . July 2008 (Chairman&Oration ).

90. 26th Annual Summer Meeting of the Egyption Society of Surgeons

Alexandria October 22-24,2008. ( Chairman&Oral presentation ).

91. Egyption Group of Gastrointestinal motility Annual Conference

Sharm-Elshekh (Chairman)11,Novmper 2008.

92. 7th International Congress Egyptian society of Laparoscopic Sourgery

(ESLS) , January 20th -22nd ,2009 Cairo-Egypt (Chairman&Oral

presentation ).

93. Workshop in colorectal surgery in Kafr-Elshick held in Jan.29,2009.

94. 4th Regional Congress of ESTIP (The Egyptian Society of Tropical

Medicine, Infectious and Parasitic Diseases). Taba, Egypt ,2009.

95. 27th Annual conference of Egyption society of Surgeous 2009.Cairo.

chairmen of cession (colorectal video cession) Oral presentation titled

conplications of pouch surgory.

96. Egyption Group of Hepatobiliary and Pancreatic Congress . portsaid

2009 (Chairman).

97. 26th Annual Summer Meeting of the Egyption Society of Surgeons

Alexandria 2009.2010-2011-2012-2013 ( Chairman&Oral presentation ).

98. 27th Annual conference of Egyption society of Surgeous 2010.Cairo.

chairmen of cession (colorectal video cession) Oral presentation titled

conplications of pouch surgory.2011-2012-2013-2014 congress

99. 28th Chairperson and lecturer in workshop of internation of

Gastroenterologists, Surgeons and on cologists, Egyption Society of

Surgeons.Feb. 2010 .

16

100. 2nd Annual conference of cardiology and gastroenterology damietta

cardiac & gastroenterology center .Doumyat 25-26 Feb. 2010 .

101. 3rd Annunal meeting of Cancer Colon symposium port said 13 May.

2010.

102. 3rd Annunal meeting (chairperson) of Egypation group of

hepatobiliary, pancreas surgeons 20-21 May. 2010.

103. 28th Annual summer meeting of the Egyptian society of surgeons ,

sept.22nd – 24th, 2010 . Helnan Palestine Hotel Alexandria , Egypt .

104. Expert meeting smposium Cairo 20/8/2010 .

105. 20th World Congress of the International association of Surgeons,

Gastroenterologists and oncologists (IASGO) ) CAIRO

INTERNATIONAL CONFERENCE 2010.

, October 20-23,2010, Cairo , Egypt .

106. 12th Annual Conference of The Egyptian Group of Colon and Rectal

Surgeons Sharm El- Sheikh, June 2010, Honary president (Chairman &

Paper Presentation ).

107. 13th Annual Conference of The Egyptian Group of Colon and Rectal

Surgeons Sharm El- Sheikh, 7-10 septmber 2011, Honary president

(Chairman & Paper Presentation ).--------2011-2012-2013 augest and

2014 GONA HURGHADA

17

INTERNATIONAL CONFERENCE: ATTENDED

1. Laser in Science and Technology. Jordon ,1988.

2. 28th International Biennial Congress of College. International

De Chirugiens Cairo November 16-21, 1992.

3. 35th International Surgery Week. Hong Kong, 1993 (Paper

Presentation)

4. 2nd Internatioal Conference of Gastroenterology .Hong Kong and

Chengdu .China , 1993 .

5. 3rd International Congress of Immune Consequences of Shock,

Trauma and Sepsis. Munich Germany , 1994 (Paper Presentation)

6. 2nd International African Conference of Study of Liver Disease. Cairo

, 1994, Egypt (Paper Presentation).

7. 1st Congress of Meditrranian Society, of Coloproctology Milano 1994

Italy (Chairman and Oral Presentation ).

8. 15th Binneal Congress of International Socciety of University of

Colon and Rectal Surgeons Singapore, 1994 (Paper Presentation )

9. 10th Workshop & Afro-Arab Conference on Liver and Biliary

Disease Cairo, 29th January, February 1994 Egypt (Paper

Presentation).

10. 1st Congress of Surgical Oncolgy Mansoura Egypt 1994 (Oral

Presentation).

11. 36th International Surgical Week, (Lisbon), (Paper Presentation) 27th

August to October , 1995.

12. IGC The 7th Congress,(Beudapest), (Paper Presesntation) &

Moderator in Poster Session 27th June to 2nd July , 1996 .

13. Panarab Association of Surgeons in Tunisa 1996.

14. 6th Congrss of Italian Society of Coloproctology September 11-

14,1996 (Paper Presentation)

18

15. International Society of Laser Surgery and Medicine (Islsm) Congress

Iix Rostock Germany September 11-13. 1997.

16. 4th Congress of Units of Coloproctology in Modena, Italy November

27-28 ,1997.

17. World Congress of European Association of Endoscopic

Surgeons June 1-6, 1998 Rome Italy .

18. Reelection of "Dr Mohamed Farid" as Vice President of

Meditrranean Society of Coloproctology (Mscp) in Rome Meeting

Monday June ,1998.

19. 38th International Surgical Week (Oral Presentation and Chairman)

Veina-Austrlia 1999.

20. First Biennial Congess Mediterranean Society of Coloproctology.

Italy Novemer 1999

21. Laparoscopic Surgery Congress and Panarab Association of Surgery

(Aleppo- Syria 2000).

22. 10th Panarab Association of Surgery and Moraco Surgical Society

(Oral Presentation And Chairman) Rabat-Moraco Novamber 2000.

23. 4th International Congress of Egyptian Group of Gastrointestinal

Motility Cairo 2000 (Chairman and Oral Presentation ).

24. 5th International Congress of Egyptian Group of Endoscopy (Pannel

Discussion) Cairo 2000.

25. 9th International Congress of Egyptian Society of Hospital Infection

(Mansoura, Egypt. October ,2000) (Chairman and Oral Presentation ).

26. International Congrees of Surgical Microbiology (Stockholm-Sweden

June 2001).

27. 8th Congress of European Counsil of Coloproctology (Oral

Presentation) Prage Chezk Republic 2001.

28. 2nd Congress of Syrian Society of Surgery Combind With

Laproscopic Surgical Society and Panarab Association of Surgery

Damascus-Syria 2001 (Chairman and Oral Presentation).

29. 3rd Annual Congress of Gastroentrology . Port Said, August 2001 .

19

30. 4th Annual Conference of The Egyptian Group of Colon and Rectal

Surgeons Shaem El- Sheikh April, 2002.

31. 20th Congress of Italian Society of Surgery Modena Italy 2002

(Chairman and Oral Presentation ).

32. Colorectal Symposium in collabration with Cliveland Clinic of

Colorectal Surgery Department 3-7 Septamber 2002.(Clevland Ohio

USA)

33. Annual Congress of Panarab Association of Surgery Kuwait

December 2002 (Chairman and Oral Presentation ).

34. 5th Annual Conference of The Egyptian Group of Colon and Rectal

Surgeons Shaem El- Sheikh April, 2003.

35. Annual Meeting of Laparoscopic Surgery of Saudi-German Hospital

in callaboration with Kensel University Germany, July 2003.(Oration)

36. 8th Congress of Colorectal Surgery Society in callaboration with

International Society of University of Colorectal Surgery Antelya-

Turkey September. 2003.( Chairman&Oral Presentation).

37. Live Transmittion Workshop in collaboration with Cleveland Clinic

Colorectal Surgery Department International Medical Center Cairo

Augest 2003. Moderator.

38. Annual Congress of Banarab Association of Surgery Trabule-Lybia

Dec. 2003. Chairman &Oration

39. 6th International Congress ( Egyptian Society of Hepatology &

Gastroentrology ) Ibd and Large Bowel Emergencies. Alexandria

Sept,2004.

40. 3rd International Conference of Egyptian Group of Laparoendoscopic

Surgeons Cairo, Taba December. 2004.

41. 16th Pan Arab Association of Surgeons, Jordon Amman 2004 [Paper

Presentation ].

42. 7th Annual Conference of The Egyptian Group of Colon & Rectal

Surgeons Sharm El-Sheikh June 2005, Chaiman.

21

43. Pan Arab Association of Surgeons 17th , Bahrain December 18, 2005

.(Chaiman – Paper Presintation ).

44. An Arab Association of Surgeons. The 34th Annual Congress of

Jordanian Surgical Society in collaboratrion with The International

Surgical Society and African Middle East Association of

Gastroenterology.Amman 2006. (Amage).Speaker.

45. The 16th Annual Congress of P28th Annual and Scientific Congress

of Alexandria Faculty of Medicine. Hospital and Healthcare

Management. Alexandria. Egypt. April 5-6, 2007

46. 25th Annual Summer Meeting of the Egyptian Society of Surgeons in

collabration with the 17th Annual Congress of the Pan Arab

Association of Surgeons. Alexandria, Egypt. September 5-7,2007.

47. 6th International Congress (The Egyptian Society of Surgeons, Group

of Laparoendoscopic Surgeons).Ain El-Sokhna, October 18th – 20th ,

2007

48. 9th International Workshop on Therapeutic Endoscopy.(Theodor

Bilharz Research Institute). Cairo , Egypt, December 8th – 10th , 2007.

49. 6th Binneal congress of M S C P and Italian socitey of colorectal

surgeous february 1-2,2008 chairman of a cession and poster

presentation(award as the best one) and accepted for publication in

Technique of coloproctolgy title of the paper : proximally based vs

distally based gluteus maximus flap in management of end stage fecal

incontinence.

50. 6th International Congress (The Egyptian Society of Surgeons, Group

of Laparoendoscopic Surgeons).Ain El-Sokhna, October 18th – 20th ,

2008.

51. 29th Tunisian congress in collaboration with 12 th Maghrebian

congress of surgery and 18 th Panarab congress of surgery (chairman

& paper presentation) April 2008 .

21

52. 6th International Congress (The Egyptian Society of Surgeons, Group

of Laparoendoscopic Surgeons).Ain El-Sokhna, October 18th – 20th ,

2009.

PUPLISHED WORK:

1. Breast Lesions in Generalised Neurofibromatosis: Breast Cancer and

Cystosarcoma Phylloides. Neurofibromatosis 121-125 (1989) .

2. Survival Rate after Acute Haemorrhage in Rabbits Treated by Xanthine

Oxidase Inhibtor (Allopurinol). The New Egyptian Journal of Medicine

6,5 Vol. (1992) – Presented in 3rd International Confers of Shock,

Sepsis and Haemorrage Held in Munich Germany March 2-5, (1994).

3. Splenic Abscess. The Arab Journal of Medicine.(1985). 4,11.

4. Gastric and Intestinal Motility after Splenectomy with and without

Nasogastric Intubation. Mansoura Medical Bulletin (1987).

5. Immunoglobulins and T-Iymphocytes after Splenectomy in Bilharzial

Patients . Benha Medical Journal 4,3 : 17 (1987).

6. Small Bowel Neomucosa. The New Egyptian Journal of Medicine 2,3 :

755 (1988).

7. Cholecystectomy in Cirrhotic and Non-Cirrhotic Patients. Zagazig

University Medical Journal.(1988).

8. T3 and T4 Changes in Patients with Toxic Goitre in Relation to

Different Methods of Preoperative Preparation. The New Egyptian

Journal of Medicine .2,3 : 759 (1988).

9. Segmental Pressure Measurements in Predicting Outcome of

Aortobifemoral Graft in Patients with Associated Superficial Femoral

Artery Occlusion. Zagazig University Medical Journal.(1989).

10. Solitary Thyroid Nodule. Zagazig University Medical Journal .12,1:

111(1989).

11. The Myoepithelium in Some Breast Lesions. Benha Medical Journal

6,2: 17 (1989).

22

12. Retrospective Clinical Study Of 33 Cases of Primary Gastro-Intestinal

Lymphoma. Zagazig University Medical Journal 12,1: 72 (1989).

13. Effect of Topical Sodium Diphenylhydantoin (Phenytoin) on Healing of

Chronic Leg Ulcers. Zagazig University Medical Journal12,1:8 (1989).

14. Benign Haemangiopericytoma of Greater Omentum. The New Egyptian

Journal of Medicine: 11, 9: 16 (1989).

15. Intussusception. Benha Medical Journal. 4, 3:9 (1989).

16. Five Years Experience in Appendectomy. Zagazig University Medical

Journal, (1989).

17. Yeast Species Isolated from Cancer Patients in Mansoura: Prevelance

And Susceptibility to Antimycotic Dotic Drugs. Journal of Tropical

Medicine. (1990).

18. Modified Dauhamel Operation for Hirchsbrung Disease’s Using Linear

Cutter 75 Mm (Gia Stapler) 3 Rd National Conference of The Egyptian

Society of Paediatric Gastroentrology and Nutrient.(1990).

19. Radio-Isotopic Study of Kidney Function in Obstructive Jaundice

Mansoura Medical Bulletin 20, 3&4 : 83-88(1990).

20. Comparative Studies on Histopathological and Serological Findings in

Belharzial Hepatic Fibrosis Benha Medical J 7,1: 75 – 80. (1990)

21. Ultrasonographic Evaluation of Scrotal Swellings. Benha M.J. 8,2 :

113-114 (1991).

22. Evaluation of Infrared Contact Photocoagulation in The Treatment of

Different Degrees of Haemorrhoids. Proceeding of Annual Scientific

Meeting of Mansoura Faculty of Medicine 13,14 February (1992).

23. Evaluation of Monoclonal Antibody CA 19-9 Tumour Marker in

Primary Diagnosis and Follow up of Colorectal Carcinoma. Egyptian

Journal Of Surgery Vol. 10, 45-49 (1992).

24. Breast Lump in Women Under The Age of Forty . Benha Medical J 75

– 74. (1992)

25. Evaluation of Varicocelectomy in Infertile Patients with Varicocele. J.

of Dermatolgists 3,1:89-93(1992).

23

26. Subcostal Incision for Cholecystectomy, Knife or Diathermy Benha

Medical J. 9,2 (1992)

27. Severe Anorectal Injuries Associated with Fracture Pelvis: Primary or

Secondary Repair Panarab Association of Surgery Cairo (1993).

28. Is there a place for Nonoperative Treatment Methods (Photocoagulation,

Barron Banding) in Third Degree Haemorrhoids. Proceeding of

Mansoura Annual Scientific Meeting, (1993).

29. “Coring out with Endorectal Repair” A new surgical approach in The

Treatment of High Anal Fistula. 11Th Annual Meeting of Egyptian

Society of Surgeons. Proceeding of Mansoura Annual Scientific

Meeting, (1993).

30. Laparoscopy for Questionable Appendicitis in Young Females.

Proceding of Mansoura Scientific Annual Meeting, (1993).

31. Crohn’s Disease Presenting with Acute Abdomen. Proceeding of

Mansoura Scientific Annual Meeting (1993).

32. Bacterial Translocation: 35th Congress of The International Society of

Surgery, Hong Kong, August 1993, [Proceeding]

33. Bacteriological and Immunological Studies in Children with Liver

Cirrhosis .Egyptian J. of Medical Microbiogy 2;31-36(1993).

34. Five Years Experience in Hepatic Trauma Proceeding of Annual

Scientific Meeting Of Mansoura Faculty Of Medicine 14: 24. (1993)

35. Ultra Sonographic and Histopathological Study of The Gall Bladder in

Bilharzial Periportal Fibrosis. Mansoura Medical J 23, 1,2: 83 – 91

(1993).

36. Five Years Experience in Managment of Upper Gastrointestinal

Hemorrhage in Children ( 45 Cases ) . Proceeding of Annual Scientific

Meeting of Mansoura Faculty of Medicine 9 – 17(1993).

37. Five Years Experience in Mangment of Peripheral Vascular Emergeny

(75 Cases) . Proceeding of Annual Scientific Meeting of Mansoura

Faculty of Medicine 1-7(1993).

24

38. Platelet Aggregation Index and Femoropoliteal Graft Patency. Banha

Medical J.10,2 : 147-154.

39. Diathermy Haemorrhoidectomy “Assisted with Infrared Contact

Photocoagulation” “ Icpc ” Xvth . Biennel Congress of The

International Society of University of Colon And Rectal Surgeons. July2

–6 Singapore (1994).

40. Coloanal J- Pouch after Resection of Low Sited Rectal Cancer. The New

Egyptian Journal of Medicine 1,1: (1994).

41. Clinico-Epidemiological Study and Treatment of Colorectal Carcinoma.

The New Egyptian Journal of Medicine 10,3: (1994).

42. Hepatobiliary Parasitic Infections of Surgical Importance (Study of 30

Cases). Presented in 2nd Conference and Postgradute Session of Africa

Association for The Study of Liver Disease Cairo March 18-22, 1994.

[Proceeding]

43. Dynamic Graciloplasty : A Neoanal Sphincter in Anal Incontinence

1994 Presented in 12th Confers of Egyptian Society of Surgeons.

[Proceeding]

44. Parathyroid Allotransplantation in patients with Post Thyroidectomy

Severe Hypocalcemia without Anti- Rejection Therapy Mansoura

Medical J 24, 8,2: 97:104 (1994).

45. Bladder Mucosal Graft Techcniqe for Hypospadius Repair (Study of 24

Cases) Mansoura Medical J. 24,3 & 4:193-203 (1994).

46. Cryosurgery(Cs) vs Infrared Contact Photocoagulation (Icpc)in The

Treatment of Some Cutaneous Haemangioma. Mansoura Medical

J.24,3&4:237-247(1994).

47. End Colostomy with Smooth Muscle Grafting; A Decent Proposal for

Colostomy Care. International Gastroclub Conference Budapest 1996 –

Mansoura Faculty of Medicine Conference. 1995. [Proceeding].

48. Anorectal Varices in Shistosomal Hepatic Fibrosis; Incidence and

Efficacy of Therapy, Xv Th. Biennel Congress of The International

Society of University Colon And Rectal Surgeons. July 2-6, Singapore.

25

European Association of Endoscopic Surgeons Journal June 1996,

[Proceeding]

49. The Double Staepled Technique ( D.S.T ) Low Colorectal Anastomosis:

Is It Worth While? Benha Medical Journal Vol 13 No 3 Sept. 1996.

50. Experience with Total Parotidectomy with Preservation of The Facial

Nerve. Benha Medical J 14,1 : 99 – 105 (1997).

51. Evaluation of Adult Patients with Chronic Constipation by

Defecography and Colonic Transit Using Radio-Opaque Markers.

Egyptian J. of Radiography &Nuclear Medicine 29,2:529-549 (1999).

52. Therapeutic Impact of Glyceryl Trinitrate in some Benign Anal

Conditions. 2nd Biennial Conference of The Egyptian Group for The

Study of Gastrointestinal Motility. (1996). Egption Society of Sur. J July

20-3, 2001

53. Evaluation of Vertical Banded Gastroplasty Trunkal Vagotomy and

Gastrojejunostomy in Management of Morbid Obesity : Study of 5

Cases. Mansoura Medical Journal Vol 32,No 3,4 July & Oct ,2001.

54. Evaluation of Roux-En-Y Gastric Bypass Procedure Operation in

Management of Morbid Obesity:Study of 15 Cases . . Mansoura Medical

Journal Vol 32,No 3,4 July & Oct ,2001.

55. Evaluation of Vertical Banded Gastroplasty Operation in Management

Of Morbid Obesity :Study of 25 Cases. Mansoura Medical Journal Vol

32,No 3,4 July & Oct ,2001.Evaluation of Overlapping Anal Sphinctric

Repair ( Oasr ) with Internal Sphincter Imbrication for Fecal

Incontinance Due to Sphinctric Injury . Benha Medical Journal Vol. 19

No. 2 May. 2002.

56. Augmented Unilateral Gluteoplasty with Fascia Lata Graft in Fecal

Incontinence. Benha Medical Journal Vol. 19 No. 1 Jan. 2002.

26

57. Hands" on and live transmission work shops :

- Satu

PUBLISHED WORK DURING PROFESSORSHIP

( all presentations in the international conferences were accepted by 3-4

peer reviewers as full text for proceeding in the official affiliated journal )

1) End Colostomy with Smooth Muscle Grafting; A Decent Proposal for

Colostomy Care. International Gastroclub Conference Budapest 1996.

Proceeding – Mansoura Faculty of Medicine Conference. 1995.

[Proceeding].

2) Anorectal varices : endoscopic dilemma. Surgical Endoscopy (journal of

European association of endoscopic surgeon;EAES; and Intervenual

Technique) JUN 1996:445-448.

3) The Effect of Somatostatin Analogue, Octrotide on The Jejunal

Mucosa of Bowel Resected Albino Rat. WJS Proceeding ISW 95, 36

World Congress of Surgery. Mansoura Medical Journal Vol. 1,2:1

(1996).

4) Does The Coloanal J – Pouch Have Similar Properties to Ano-Rectum ?

Benha Medical J 13,3 : 240 – 245(1996).

5) Dynamic Graciloplasty with Obturator – Pudendal Nerve Anastomsis. Is

It Myth or Reality? Mansoura Faculty of Medicine, Pediatric Conference

1995, 4th Congress of Italian Society of Coloproctology Torino Italy 1996

[Proceeding].

6) The Double Stapled Technique in Low Colorectal Anastomosis Is it

worthwhile ? Benha Medical J 13,43 : 255 – 265 (1996).

7) Modified Duhamel Using Linear Outer Gia 75mm vs Modified

Swanson in Hirshsprings Disease. Benha Med. J 14,1:107–113 (1997).

8) Evaluation of Adult Patients with Chronic Constipation by

Defecography and Colonic Transit Using Radiopaque Markers, The

27

Egyptian Journal of Radiology & Nuc. Med. , Vol. 29, No. 2, (Dec.):529-

549, 1998.

9) Gut Ischemia & Oxiditive Stress in Pneumo- Peritonium Expermintal

Study Mansoura Medical J 29 , 3&4 July& October,1999.

10) The Use Of Unilateral Gluteus Maximus Muscle For The Mangment

of Fecal Incontinence Following Anorectol Surgery Technique in

Coloproctology 4,1 :7 – 12(2000).

11) Severe Anorectal Injuries Associated with Fracture Pelvis: Primary or

Secondary Repair Panarab Association of Surgery Cairo (2001). 20th

Congress of Italian Society of Surgery.

12) Evaluation of Roux En Y Gastic Bypass Procedure Operation in

Management of Morbid Obesity Mans. Med J.32,3&4 2001.

13) Encopresis in Children Impact of Anxiety and Depression Symposium

of Lower Gut Disorder. Mansoura Medical J. (2001).

14) Evaluation of Vertical Banded Gastroplasty Operation In Mangnent

of Morbid Obesity: Study of 25 Cases Mansoura Medical J. 32 No. 3,4

July & Oct 121-135 (2001).

15) Transperineal with or without Levatoroplasty vs. Transanal Repair for

Rectocele in Obst. Defecation Egyptian J. of Surgery, 21 , No. 3 , July

(2002).

16) Evaluation of Different Treatment Modalites in Dukes B and C Rectal

Adenocarcinoma. Medical J of Cairo Unversity (Accepted In 4/3/2002).

17) Evaluation of Overlapping anal Sphenctric Repair ( OASR ) with

Internal Sphincter Imprication for Fecal Incontinence Due to

Sphincteric Injury Benha Med. J. 19,2:27 2002 .

18) Research Design . Egyptian Journal of Surgery Vol. (21), No. 4 , Oct.,

2002.

19) Professional Development How to Write A Research Proposal

(Protocol) Eg. J Surg 21,1:2002.Professional Development Sample Size

Eg. J Surg 22,2 :111-114, 2003.

28

20) M.Farid, H.A. Moneim. T. Mahdy. W. Omer. (2003)., "Augmented

Unilateral Gluteoplasty with Fascia Lata Graft in Fecal Incontince"

Tech. in Coloproctology, 7 No. April 23-28 .51)

21) How to Present A Paper at A Scientific Meeting. Egyptian J of

Surgery, 23 No. 4 Oct (2004).

22) Professional Development (Handing Surgical Data Exploratry Data

Analysis) EJS October 2004.

23) Nabil Dowidar, Mohamed Farid, Ahmed Hussein,Ahmed Hazem . ,

Jan. , 2004.,"Tips on Writing :A Scientific Paper" Egyptian Journal of

Surgery Vol. (23), No. 1 .

24) Professional Development (Tips on Writing References) Egyptian

Journal of Surgery Vol. (23), No. 3 , July. , 2004.

25) Fecal Fistula: What Is New? Egyptian Journal of Surgery Vol. (23),

No. 4 , Oct. , 2004.

26) Utility of Preoperative Serum Carcinoemberyonic Antigen in

Colorectal Cancer Patients , Benha Medical Journal , Vol. 21 No. 3,

Sep. 2004 .

27) Professional Development. How To Appraise an Article on Surgical

Therapy. April, 2005.

28) Manometric studies, endorectal U.S and incont score after closed

lateral sphenctrotomy ,convential and tailored;a randomised prospective

study.EJS 24,1 2005: 36-4 .

29) Said Rateb, Nabil Dowidar, Mohamed Farid, Ahmed Hussein, Ahmed

Hazem. July,2005. "How to Appraisa an article on diagnosis" ,

Vol.(24), No.(3),2005.

30) Nabil Dowidar, Ahmed Hazem, Said Rateb, Mohamed Farid Ahmed

Hussein . July,2006. "Audit Objectives and standards , Journal of

surgery", Vol.(25), No.(3), 2006.

31) Hosama El- wakeel, Hesam Abd el- Moneim , Mohamed Farid, and

A.A. Gohar 14 March 2006, 7 Agust 2006," Clove Oil Cream: a new

29

effective treatment for chronic anal fissure." International Journal of

Colorectal Disease,9, 549-552.

32) Professional Development: Disclosure. EJS. July, 2006.

33) Evolution of Colorectal Cancer in Schistosomiasis. Egyptian Journal

of Surgery Vol. (25), No. 4 , Oct. , 2006.

34) Professional Development How to Select an Audit Sample. Egyptian

Journal of Surgery Vol. (25), No. 4 , Oct. , 2006.

35) Nabil Dowidar, Ahmed Hazem, Said Rateb, Mohamed Farid, Ahmed

Hussein . April. , 2007, Making change , Vol. (26), No. (2) ,.

36) Early oral feeding VS delayed oral feeding in patients undergoing

intestinal resection ,EJS.26,1 January : 33-38,2007 .

37) Nabil Dowidar, Ahmed Hazem, Said Rateb, Mohamed Farid Ahmed

Hussein . Jan ,2007, Audit Design Vol.(26), No.(1) .

38) Professional Development. Audit Report, EJS.Vol.(26), No.(3),

July,2007.

39) Yosses T., Mahdy T., Farid M., Latif AA.(2008 Aug); Thyroid Surgery

: use of the ligasure vessel sealing system versus conventional knot tying

. Int J Surg. 6(4): 323-7.EPUB.

40) Original Article. Randomized,Clinical Trial of Ligasure

Haemorhoidectomy Versus Conventional "Ferguson"

Haemorhoidectomy. EJS.Vol.(26), No.(3),July,2007. Technique of

coloproctolgy 2009 13(3):243-6.

41) Nabil Dowidar, Ahmed Hazem, Said Rateb, Mohamed Farid Ahmed

Hussein July. , 2008. " Research Misconduct-I Vol. (27), No. (3),.

42) Salehel-Awady,Ayman M.Ali,Osama Kumbwe, Sied AbdEl-Maksoud,

Mohamed Farid, (2008) ."Tibial corticotomy and periosteal elevation for

chronic critical lower limb ischaemia " . Acta orthopaedica belgica

July(Vol;74.),

43) Ayman ElNakeeb, Amir Fikry, Waleed Omer, Elyamani Fouda, Tito El-

Metwally, Hosam Ghazy, Sabry Badr, Mohamed Abu Elkhar,Salih

Elawady , Hisham Abd El moniam, Waiel khafagy, Mosaad Morshed,

31

Ramadan El lithy, Mohamed Farid,( 2008 November), "Rubber band

ligation for 750 cases of symbtomatic haemorrhoids out of 2200 cases

".World Journal Gastroenterol ; 14;14(42),.

44) AymanEl-Nakeeb, Amir Fikry,Tito M.AbdEl-Hamed, El-Yamani

Fouda, , Hosam Ghazy, Sabry badr, Wael Khafagy, Mohamed Farid,

(2009)," Early oral feeding in patients undergoing colonic anastomosis

".International Journal of Colorectal Disease.7 (2009) 206-209 ,.

45) AymanEl-Nakeeb, Amir Fikry,Tito M.AbdEl-Hamed, El-Yamani

Fouda, Saleh El- Awady, Tamer Youssef, Doaa Sherief, Mohamed Farid,

(2009) "Effect of Helicobacter pylori eradication on ulcer recurrence

after simple closure of perforated duodenal ulcer " International Journal

of Surgery 7 (2009) 126-129 .

46) ElAwadi S., El Nakeeb A., Youssef T., Fikry A., Abd El- Hamed TM.,

Ghazy H., Fouda E., Farid M., (2009),. "Laparoscopic versus open

cholecystectomy in cirrhotic patients:A prospective randomized study".

International Journal of Surgery 7(2009) 66-6, .

47) Farid M., El-Monem HA., Omar W., El Nakeeb A., Fikry A., Youssef

T., Youssef M., Ghazy H., Fouda E., El Metwally T., Khafagy W.,

Ahmed S., El- Awady S, Morshed M., El-Lithy R.,. (2009) " Comparative

study between biofeedback retraining and botulinum neurotoxin in the

treatment of anismus patients " International Journal of Colorectal

Disease24:327-334., .

48) Saleh El-Awady, Lithy R., Morshed M., KhafagyW., Abd Monem H.

Waleed Omer. Badr S., El- Nakeeb A., Ghazy H., El- Yamany M.,

Metually T., Mohamed El- Armar.MD. Mohamed Farid M.D. (2009),

"Utility of serum preoperative Carcinoemberyonic Antigen in Colorectal

Cancer Patients " the Hepato-Gstroentrology Journal 56:361-366.,

49) "Maximus Muscle Flap in treatment of end stage fecal Incontinence "

Of Techniques in Coloprctology 2009 .

50) Mohamed Farid , Tamer Yossef, Tarek Mahdy, Waleed Omer, Hesham

Abdul Moneim, Ayman El-Nakeeb, Mohamed Yossef . 2009 Mar,

31

Comparative study between botulinum toxin injection and partial

division of puborectalis for treating anismus.Int j Colorectal Dis. 24(3):

327-34., .

51) Khafagy W., El- Nakeeb A., Fouda E., Omer W., Elhak NG., Farid M.,

Elshobaky M., 2009 Jul-Aug; Conventional haemorrhoidectomy, stapled

haemorrhoidectomy, Doppler guided haemorrhoidectomy artery

ligation; post operative pain and anorectal manometric assessment.

Hepatogastroenterology. 56(93):1010-5.61- 58- 58- .

52) Farid M., El- Nakeeb A., Youssef M., Omer W., Fouda E., Youssef T.,

Thabet W., Elmoneum HA., Khafagy W., 2009 Sep; Idiopathic

hyertensive anal canal : a place of internal sphincterotomy. J

Gastrointest Surg. 13(9): 1607-13.one of top 50 month

53) Mohammed Farid, M.D. Amir Fikry, M.D., Ayman El Nakeeb, M.D.,

Elyamani Fouda, M.D.,Tito Elmetwally, M.D., Mohamed Yosef,

M.D.,and waleed Omer,M.D., 15 July 2009 , Clinical Impacts of Oral

Gastrografin Follow-Through in AdhesiveSmall Bowel Obstruction

(SBO) Journal of Surgical Research,1-7(2009), 15 July 2009 154 No.2.

54) Farid M, Youssef M, El Nakeeb A, Fikry A, El Awady S, Morshed M.

Comparative study of the house advancement flap, rhomboid flap, and y-v

anoplasty in treatment of anal stenosis: a prospective randomized study.

Dis Colon Rectum. 2010 May;53(5):790-7.

55) Khafagy W, Omar W, El Nakeeb A, Fouda E, Yousef M, Farid M.

Treatment of Anal Fistulas by Partial Rectal Wall Advancement Flap or

Mucosal Advancement Flap: A Prospective Randomized Study. Int J Surg.

2010 Apr 10.

56) El Nakeeb A, Askar W, El Lithy R, Farid M. Clipless laparoscopic

cholecystectomy using the Harmonic scalpel for cirrhotic patients: a

prospective randomized study. Surg Endosc. 2010 Apr 8

57) Farid M, Madbouly KM, Hussein A, Mahdy T, Moneim HA, Omar W.,

2010 Apr. Randomized controlled trial between perineal and anal repairs

32

of rebnctocele in obstructed defecation. World J Surg. 2010 Apr;34(4):822-

9.

58) Elbanna HG, Abbas AM, Zalata K, Farid M, Ghanum W, Youssef M,

Thabet WM, El Awady S, El-Sattar MH. 2010, Effects of ovarian failure on

submucosal collagen and blood vessels of the anal canal in

postmenopausal women.Int J Colorectal Dis. 2010 Apr;25(4):477-83.

59) Madbouly KM, Hussein A, Omar W, Farid M.,Jun., 2010 , Regenerated

oxidized cellulose reinforcement of low rectal anastomosis: do we still need

diversion?Dis Colon Rectum. 2010 Jun;53(6):889-95.

60) Faried M, El Nakeeb A, Youssef M, Omar W, El Monem HA. 2010 May

Comparative Study between Surgical and Non-surgical Treatment of

Anismus in Patients with Symptoms of Obstructed Defecation: A

Prospective Randomized Study . J Gastrointest Surg. 2010 May 25 14:1235-

1243 .

61) Elymani Fouda , Ayman El- Nakeeb , Alaa Magdy , Enas A. Hammed ,

Gamal Othman , Mohamed Farid , 2010, Early Detection of Anastomotic

Leakage After Elective Low Anterior Resection , J Gastrointest Surg, 27

October 2010 .

62) S.A. Mohmoud, W.Omar and M. Farid 2010, Transanal repair fortreament

of rectocelein obstructed defaecation : manual or stapled . J Colorectal

disease.

Tibial corticotomy and periosteal elevation

induce angiogenesis in chronic critical limb

ischaemia.

Acta Orthop Belg. 2008 Dec;74(6):823-30. El-Awady S, Ali AM, Kumber O, El-Maksoud SA, Fareed M.

Source

Department of Surgery, Mansoura University, Mansoura, Egypt.

33

Abstract

Corticotomy and periosteal elevation as a surgical procedure for management of chronic critical

limb ischaemia is a relatively new technique. The current study aimed at assessing its safety,

efficiency and cost/benefit ratio. The procedure was performed in 36patients. Preoperative

documentation for age, sex, co-morbidities, ankle systolic pressure, and magnetic resonance

contrast angiography was obtained. Early results included evaluation of skin perfusion. Late

results involved assessment of wound healing, which was documented with photographs and

was graded (healed, healing, resistant, recurrent), pain (intermittent claudication and pain at

rest), Kelkar score, procedure morbidity, patient satisfaction and quality of life. Mean age was

68.03 +/- 5.5 years; 23 patients were males (63.9%) and 13 females (36.1%). Twenty (55.6%)

patients had ankle systolic pressure < 50 mmHg and 29 (80.5%) had infra-inguinal vascular

disease. Skin perfusion improved in 33/36 patients (91.7%). At final follow-up, 34 patients

(94.1%) achieved complete wound healing. Relief from ischaemic rest pain and intermittent

claudication was achieved in 86.1% and 55.6% respectively, with 20 (55.6%) patients having

an excellent Kelkar score. Only one patient required a major amputation. Morbidity was noted

in 17.7% of cases. Patient satisfaction scores at 12 months and at final follow-up were 7.1 +/-

1.3, and 8.7 +/- 1.7 respectively, on a scale from 0 to 10. Quality of life was markedly

improved as compared to the preoperative status (overall score: p = 0.05, mental health scale: p

<0.05 and pain/anxiety domain: p < 0.001). The procedure appears to represent an interesting

tool, which should be evaluated in randomised studies. Our findings support the postulated

angiogenic effect of the fracture haematoma.

PMID:

19205331

[PubMed - indexed for MEDLINE]

Rubber band ligation for 750 cases of

symptomatic hemorrhoids out of 2200 cases.

World J Gastroenterol. 2008 Nov 14;14(42):6525-30. El Nakeeb AM, Fikry AA, Omar WH, Fouda EM, El Metwally TA, Ghazy HE, Badr SA, Abu

Elkhar MY, Elawady SM, Abd Elmoniam HH, Khafagy WW, Morshed MM, El Lithy RE,

Farid ME.

Source

Department of General Surgery, Colorectal Unit, Mansoura University Hospital, Mansoura

335111, Egypt. elnakeebayman@yahoo.com

Abstract

AIM:

To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation

(RBL) method.

METHODS:

A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to

September, 2006, data was retrieved from archived files. RBL was performed using the Mc

Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic

34

for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years).

RESULTS:

After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third

degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years.

A total of 52 patients (6.93%) had 77 complications from RBL which required no

hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms (4.13%,

4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in

mean SF-36 scores over baseline in five items, while after 2 years there were improvement in

all items over baseline, but not significant. No significant manometeric changes after band

ligation.

CONCLUSION:

RBL is a simple, safe and effective method for treating symptomatic second and third degree

hemorrhoids as an out patient procedure with significant improvement in quality of life. RBL

doesn't alter ano-rectal functions.

PMID:

19030206

[PubMed - indexed for MEDLINE]

PMCID:

PMC2773340

Free PMC Article

Effect of Roux-en Y gastric bypass on bone

metabolism in patients with morbid obesity:

Mansoura experiences.

Obes Surg. 2008 Dec;18(12):1526-31. Epub 2008 Aug 21. Mahdy T, Atia S, Farid M, Adulatif A.

Source

Mansoura Faculty of Medicine, El Mansura, Egypt. tmahdy@yahoo.com

Abstract

BACKGROUND:

Roux-en-Y gastric bypass (RYGBP) has been found to be the most efficient way to lose weight

and maintain the weight loss in morbid obesity. However, with the formation of a new stomach

and the modification of intestinal anatomy, there are significant changes on bone metabolism.

The objectives of this study were to evaluate effects of weight loss on bone metabolism after

Roux-en Y gastric bypass in patients with morbid obesity.

METHODS:

35

Our study included 70 patients with morbid obesity; RYGB was done for all patients. Daily

postoperative oral supplementation with 1,000 mg of calcium and 800 IU of vitamin D was

done for each patient. Body weight (BW), body mass index (BMI), total body fat, total lean

tissue mass, bone mineral content (BMC), bone mineral density (BMD), total bone area (TBA;

using dual energy X-ray absorptiometry), serum calcium, parathyroid hormone (PTH), 25-OH

vitamin D, 24-h urinary calcium, and bone-specific alkaline phosphatase (BSAP) were assessed

preoperatively and 1 year after surgery.

RESULTS:

In our study, females comprised 70% of cases. The mean age was 35+/-8.8 years. One year

after RYGB, BW decreased significantly from 132.8+/-26.5 to 90.3+/-17.3 kg (p=0.001). BMI

decreased significantly from 48+/-7.3 to 32.6+/-4.1 kg/m(2) (p=0.001). BMC decreased

significantly from 2,968.6+/-71.4 to 2,700.8+/-45.4 g (p=0.001). BMD decreased significantly

from 1.026+/-0.03 to 1.22+/-0.015 g/cm(2) (p=0.001). TBA decreased significantly from

2,356.2+/-35.4 to 2,216.3+/-43.5 cm(2) (p=0.001). Serum calcium, 24-h urinary calcium, and

BSAP were not significantly decreased while 25-OH vitamin D and PTH were not significantly

increased after surgery.

CONCLUSIONS:

From this study, it is shown that RYGBP operation gives very good results as regards reduction

of body weight in morbidly obese patients. Postoperative supplementation with calcium and

vitamin D partially corrects osteoporosis. Thus, these patients need periodic follow-up for

BMD, PTH, calcium, serum vitamin D, and markers of bone resorption and formation specially

postmenopausal female.

PMID:

18716852

[PubMed - indexed for MEDLINE]

Clinical impacts of oral gastrografin follow-

through in adhesive small bowel obstruction

(SBO).

J Surg Res. 2010 Aug;162(2):170-6. Epub 2009 May 8. Farid M, Fikry A, El Nakeeb A, Fouda E, Elmetwally T, Yousef M, Omar W.

Source

Department of General Surgery, Colorectal Surgery Unit, Mansoura University, Mansoura,

Egypt.

Abstract

BACKGROUND:

Many studies have shown that gastrografin can be used for diagnosis of adhesive small bowel

obstruction (ASBO) and for assessing the need for surgical intervention. However, several

studies have reported conflicting results. Therefore, the aim of this study is to assess the

diagnostic and therapeutic effect of gastrografin in ASBO.

36

PATIENTS AND METHODS:

Altogether, 110 patients with ASBO were randomized into control and gastrografin groups. In

the gastrografin group, 100 mL of the dye was administered through a nasogastric tube.

Obstruction was considered complete if the contrast failed to reach the colon on the 24-h film.

Patients with gastrografin in the colon within 24 h after dye administration were considered as

partially obstructed, and were submitted to nonoperative treatment. The patients were operated

on if they developed signs of strangulation or failed to improve within 48 h.

RESULTS:

The overall operative rate was 14.5% in gastrografin group versus 34.5% in control group,

P=0.04. The time from admission to resolution of symptoms was significantly lower in

gastrografin group (19.5 versus 42.6 h, P=0.001), and the length of hospital stay was shorter in

gastrografin group (3.8 versus 6.9 d 0.002), and in nonoperative patients (3.1 versus 5.1 days).

Sensitivity, specificity, positive predictive value, and negative predictive value for gastrografin

follow-through as an indicator for operative treatment of ASBO were 87.5%, 100%, 100 % ,

and 97.9%, respectively.

CONCLUSIONS:

Oral gastrografin helps in the management of ASBO. Oral gastrografin is safe and reduces the

operative rate and time of resolution as well as hospital stay.

Copyright 2010 Elsevier Inc. All rights reserved.

Comparative study between surgical and

non-surgical treatment of anismus in

patients with symptoms of obstructed

defecation: a prospective randomized study.

J Gastrointest Surg. 2010 Aug;14(8):1235-43. Epub 2010 May 25. Faried M, El Nakeeb A, Youssef M, Omar W, El Monem HA.

Source

Mansoura University Hospital, Mansoura, Egypt.

Abstract

PURPOSE:

This study came to compare the results of biofeedback retraining biofeedback (BFB),

botulinum toxin botulinum type A (BTX-A) injection and partial division of puborectalis

(PDPR) in the treatment of anismus patients.

PATIENTS AND METHODS:

Consecutive patients treated for anismus fulfilled Rome II criteria for functional constipation at

our institution were evaluated for inclusion. Participants were randomly allocated to receive

BFB, BTX-A injection, and PDPR. All patients underwent anorectal manometry, balloon

37

expulsion test, defecography, and electromyography activity of the anal sphincter. Follow up

was conducted weekly in the first month then monthly for about 1 year. Study variables

included clinical improvement, patient satisfaction, and objective improvement.

RESULTS:

Sixty patients with anismus were randomized and completed the study. The groups differed

significantly regarding clinical improvement at 1 month (50% for BFB, 75%BTX-A injection,

and 95% for PDPR, P = 0.006) and differences persisted at 1 year (30% for BFB, 35%BTX-A

injection, and 70% for PDPR, P = 0.02). Constipation score of the patients significantly

improved postPDPR and BTX-A injection. Manometric relaxation was achieved significantly

in the three groups.

CONCLUSION:

Biofeedback retraining has a limited therapeutic effect, BTX-A injection seems to be successful

for temporary treatment but PDPR is found to be an effective with lower morbidity in contrast

to its higher success rate in treating anismus.

PMID:

20499203

[PubMed - indexed for MEDLINE]

Comparative study of conventional lateral

internal sphincterotomy, V-Y anoplasty, and

tailored lateral internal sphincterotomy with

V-Y anoplasty in the treatment of chronic

anal fissure.

J Gastrointest Surg. 2012 Oct;16(10):1955-62. Epub 2012 Aug 7. Magdy A, El Nakeeb A, Fouda el Y, Youssef M, Farid M.

Source

Mansoura University Hospital, Mansoura, Egypt.

Abstract

BACKGROUND:

Lateral internal sphincterotomy has been proven highly effective in curing anal fissure but with

a high incidence of postoperative incontinence.

OBJECTIVE:

We compared conventional lateral internal sphincterotomy, V-Y advancement flap, and

combined tailored lateral internal sphincterotomy with V-Y advancement flap in treating anal

fissure.

38

PATIENTS:

Consecutive patients treated for anal fissure at our colorectal unit were evaluated for inclusion.

Participants were randomly allocated to receive conventional sphincterotomy (GI), V-Y

advancement flap (GII), or combined tailored lateral sphincterotomy with V-Y advancement l

flap (GIII).

MAIN OUTCOME MEASURES:

The primary outcome measure was the incontinence rate; secondary outcomes included healing

rate, operative time, anal manometery, and recurrence rate.

RESULTS:

One hundred fifty patients with chronic anal fissure were randomized. Healing rate after 1 year

was 84% in GI, 48% in GII, and 94% in GIII, respectively (P = 0.001). The recurrence rate was

4% in G1, 22% in GII, and 2% in GIII (P = 0.01). Incontinence rate was 14% in GI, 0% in GII,

and 2% in GIII (P = 0.03).

CONCLUSION:

Although all three procedures are simple and easy to perform, tailored lateral internal

sphincterotomy with V-YF appears to produce the greatest healing rate, with the fewest

complications and less rate of recurrence.

PMID:

22869534

[PubMed - in process]

Early detection of anastomotic leakage after

elective low anterior resection.

J Gastrointest Surg. 2011 Jan;15(1):137-44. Epub 2010 Oct 27. Fouda E, El Nakeeb A, Magdy A, Hammad EA, Othman G, Farid M.

Source

General Surgery Department, Colorectal Unit, Mansoura University Hospital, Mansoura,

Egypt.

Abstract

BACKGROUND:

Colorectal anastomotic leakage is a serious complication leading to major postoperative

morbidity and mortality. In the present study, we investigated the early detection of

anastomotic leakage before its clinical presentation.

METHOD:

Fifty-six patients with rectal cancer were included prospectively in this study. All patients

underwent elective low anterior resection. Peritoneal samples were collected from the

39

abdominal drains at the first, third, and fifth days postoperatively for bacteriological study

(quantitative cultures for both aerobes and anaerobes) and cytokines (IL-6, IL-10, TNF)

measurement. Patients were divided into two groups: those without symptomatic or clinical

evidence of anastomotic leakage (AL; group 1) and those with clinical evidence of AL (group

2). Study variables included hospital stay, wound infection, operative time, blood loss, height

of anastomosis, intraperitoneal cytokines, and microbiological study of peritoneal fluid.

RESULT:

Clinically evident AL occurred in eight patients (14.3%) and diagnosed postoperatively on

median day 6. Intraperitoneal bacterial colonization and cytokine levels were significantly

higher in patients with clinical evidence of AL. Wound infection was significantly higher in

anastomotic leakage group. The hospital stay for the patients with anastomotic leakage was

significantly longer than those without AL (14 ± 1.41 vs. 5.43 ± 0.89 days). A significant

difference among two groups was observed regarding operative time, blood loss, blood

transfusion, and height of the anastomosis.

CONCLUSION:

The peritoneal cytokines levels and intraperitoneal bacterial colonization might be an additional

diagnostic tool that can support the decision making of surgeons for early detection of

anastomotic leak in colorectal surgery.

PMID:

20978948

[PubMed - indexed for MEDLINE]

Regenerated oxidized cellulose

reinforcement of low rectal anastomosis: do

we still need diversion?

Dis Colon Rectum. 2010 Jun;53(6):889-95. Madbouly KM, Hussein A, Omar W, Farid M.

Source

Department of Surgery, University of Alexandria, Alexandria, Egypt.

khaled.madbouly@alexmed.edu.eg

Retraction in

• Madbouly K, Hussein A, Omar W, Farid M. Dis Colon Rectum. 2011 May;54(5):656.

Abstract

PURPOSE:

The leak rate after low anterior resection is in the region of 10% to 15%. The highest risks of

anastomotic leak are in anastomoses less than 5 cm from the anal verge. We evaluated the

outcome of oxidized regenerated cellulose reinforcement of low rectal anastomosis.

METHODS:

41

The study group consisted of 108 patients with rectal cancer. Patients with low rectal cancer

had low anterior resection with stapled straight low colorectal or coloanal anastomosis without

proximal diversion. They were prospectively randomized to either oxidized regenerated

cellulose reinforcement or no reinforcement. Data collected included age, sex, hemoglobin

percentage, albumin level, histopathologic type of the tumor, anastomotic leak, and stricture.

RESULTS:

The mean age of patients was 56 years, and sex was matched in both groups. Clinical leak

occurred in 6 of 38 cases (15.7%) in the group that did not undergo reinforcement versus 2 of

33 (6.1%) in the oxidized regenerated cellulose reinforcement group (P < .01). In the case of a

leak, diversion was needed in 3 of 6 patients in the group that did not undergo reinforcement vs

no patients in the oxidized regenerated cellulose reinforcement group (P = .05). Generalized

peritonitis occurred in 3 patients in the group that did not undergo reinforcement versus no

patients in the oxidized regenerated cellulose reinforcement group (P < .01). Length of stay was

4.8 days in the oxidized regenerated cellulose reinforcement group versus 5.9 days in the group

that did not undergo reinforcement (P = .047), with no mortalities in either group.

CONCLUSION:

Oxidized regenerated cellulose reinforcement of low rectal anastomosis significantly decreases

the risk of postoperative leak in low rectal anastomosis and may reduce the requirement for

proximal diversion. Potential benefits include avoidance of a stoma, lower morbidity, shorter

hospital stay, and a lower cost of care.

Comment in

• Anastomotic leak: should we continue to accept the risks? [Dis Colon Rectum. 2010]

Comparative study of the house

advancement flap, rhomboid flap, and y-v

anoplasty in treatment of anal stenosis: a

prospective randomized study.

Int J Colorectal Dis. 2009 Jan;24(1):115-20. Epub 2008 Aug 22. Farid M, Youssef M, El Nakeeb A, Fikry A, El Awady S, Morshed M.

Source

Department of General Surgery, Colorectal Surgery Unit, Mansoura University, Mansoura,

Egypt.

Abstract

PURPOSE:

Anal stenosis represents a technical challenge for surgical management. We compared the

effects of house flap, rhomboid flap, and Y-V anoplasty procedures in a randomized study in

patients with anal stenosis.

41

METHODS:

Consecutive patients treated for anal stenosis at our institution were evaluated for inclusion.

Participants were randomly allocated to receive house flap, rhomboid flap, or Y-V anoplasty.

Follow-up visits were after 1 week, 1 month, 6 months, and 1 year. Study variables included

caliber of the anal canal (measured with a conical calibrator), clinical improvement, patient

satisfaction (visual analog scale), incontinence (Pescatori incontinence scale), and quality of

life (GI Quality of Life Inventory).

RESULTS:

: Sixty patients with anal stenosis were randomized and completed the study. Operative time

was 62 +/- 10 minutes for house flap, 44 +/- 13 minutes for rhomboid flap, and 35 +/- 9

minutes for Y-V anoplasty (P = .042). At 1 year, anal caliber was 23.9 +/- 2.33 mm for house

flap, 18.1 +/- 2.05 mm for rhomboid flap, and 16.4 +/- 2.05 mm for Y-V anoplasty (P = .04),

with a highly significant increase for the house flap (P = .001). The groups differed

significantly regarding clinical improvement at 1 month (95% for house flap, 80% for

rhomboid flap, and 65% for Y-V anoplasty, P = .01) and differences persisted at 1 year.

Significant differences were seen among groups at 1 year in GI Quality of Life Inventory

scores (P = .03), with significant improvement only for the house flap (P = .01).

CONCLUSION:

Anal stenosis can be effectively managed with the house flap procedure, with the sole

disadvantage of longer operative time. Although all 3 procedures are simple and easy to

perform, the house flap appears to produce the greatest clinical improvement, patient

satisfaction, and improvement in quality of life, with the fewest complications.

PMID:

20389213

[PubMed - indexed for MEDLINE]

Effects of ovarian failure on submucosal

collagen and blood vessels of the anal canal

in postmenopausal women.

Int J Colorectal Dis. 2010 Apr;25(4):477-83. Epub 2009 Nov 10. Elbanna HG, Abbas AM, Zalata K, Farid M, Ghanum W, Youssef M, Thabet WM, El Awady

S, El-Sattar MH.

Source

Department of General and Colorectal Surgery, Faculty of Medicine, Mansoura University,

Mansoura, Egypt. hosamelbanna@hotmail.com

Abstract

BACKGROUND:

42

Estrogen and progesterone receptors are expressed in the anal canal. Fecal control deteriorates

after menopause. This phenomenon is related to decreased circulating levels of estrogen and

progesterone due to ovarian failure at menopause.

AIM OF WORK:

To study the effects of estrogen and progesterone on inflammatory cells, submucosal collagen

fibers, and vascular plexus of the anal canal of postmenopausal women.

SUBJECTS AND METHODS:

Experiments were performed on samples of anorectal tissue obtained from 40 women, 19

menstruating (group I), and 21 postmenopausal women (group II). Investigations included

immunohistochemistry of estrogen and progesterone receptors and CD34.

RESULTS:

In negative estrogen receptors (ER) and progesterone receptors (PR), inflammatory cells,

submucosal blood vessels, collagen type I were nonsignificantly changed in postmenopausal

women relative to menstruating women (P > 0.05) whereas, in positive ER and PR,

inflammatory cells and collagen I were significantly increased and submucosal blood vessels

were significantly decreased in postmenopausal women relative to menstruating women (P <

0.05).

CONCLUSION:

Estrogen and progesterone, in menstruating women, produce beneficial effects by decreasing

incidence of inflammation and increasing anal canal submucosal blood vessels number and

collagen types I, thus both hormones have a positive effect on anal compliance and pressure.

PMID:

19902226

[PubMed - indexed for MEDLINE]

Treatment of anal fistulas by partial rectal

wall advancement flap or mucosal

advancement flap: a prospective randomized

study.

Int J Surg. 2010;8(4):321-5. Epub 2010 Apr 11. Khafagy W, Omar W, El Nakeeb A, Fouda E, Yousef M, Farid M.

Source

General Surgery Department, Colorectal Unit, Mansoura University Hospital, Elgomhoria

street, Pox 35111, Mansoura, Egypt. wkhafagy@mans.edu.eg

Abstract

BACKGROUND:

43

High transphincteric perianal fistula represents a technical challenge for surgical management.

We compared the effects of partial rectal wall advancement flap versus the mucosal

advancement flap in the treatment of high transphincteric perianal fistula in a randomized study

in patients with anal fistula.

PATIENTS AND METHOD:

Consecutive patients treated for transphincteric anal fistula at our institution were evaluated for

inclusion. Participants were randomly allocated to receive Group I: Fistulectomy, closure of

internal sphincter and rectal advancement flap includes mucosa, submucosa, and circular

muscle layer sutured 1 cm below the level of internal opening or Group II: The same as group

one but the flap includes only mucosa and submucosa. Study variables included fistula closure

rate, continence, morbidity, postoperative pain, hospital stay and quality of life.

RESULTS:

Forty patients with high transphincteric perianal fistula were randomized and completed the

study. Operative time was 31.6 +/- 6.8 min in group I, and 29.4 +/- 4.7 min in group II (P =

0.783). Hospital stay was significantly more in group 2 (96.35 +/- 9.5 vs. 105.8 +/- 13.23) (P =

0.014) Immediate postoperative complications, occurred in one patients (5%) exposed to

disruption in group I and 6 patients (30%) in group II. Recurrence occurred in 2 patients (10%)

in the group I and 8 patients (40%) in group II. Two patients (10%) in group I developed

incontinence for flatus and no patients in the group II develop such complication.

CONCLUSION:

Partial thickness advancement flap is better than mucosal advancement flap.

Copyright (c) 2010. Published by Elsevier Ltd.

PMID:

20388562

[PubMed - indexed for MEDLINE]

Clipless laparoscopic cholecystectomy using

the Harmonic scalpel for cirrhotic patients:

a prospective randomized study.

Surg Endosc. 2010 Oct;24(10):2536-41. Epub 2010 Apr 8. El Nakeeb A, Askar W, El Lithy R, Farid M.

Source

Department of General Surgery, Mansoura University, Mansoura, Egypt.

elnakeebayman@yahoo.com

Abstract

BACKGROUND:

Improved laparoscopic experiences have made laparoscopic cholecystectomy (LC) feasible

44

options for cirrhotic patients. This study aimed to compare the traditional method for LC with

LC using the Harmonic scalpel in terms of safety and efficacy for cirrhotic patients.

METHODS:

In this study, group A (60 patients) underwent LC by the traditional method (TM) with clipping

of both the cystic duct and artery and dissection of the gallbladder by diathermy, and group B

(60 patients) had LC performed using Harmonic scalpel (HS) closure and division of both the

cystic duct and artery with dissection of the gallbladder by the HS. The perioperative data were

recorded.

RESULTS:

The operation with the Harmonic scalpel was performed in less time than TM (45.17 ± 10.54

vs. 69.71 ± 13.01 min; p = 0.0001). The intraoperative blood loss was significantly more with

TM (133 ± 131.13 l vs. 70.13 ± 80.79 ml; p = 0.002). The conversion rate was 5% with TM and

3.3% with HS (p = 0.65). The incidence of gallbladder peroration was lower in the HS group

(10% vs. 18.3%; p = 0.03). Bile leak was encountered in 1.7% with HS and 3.3% with TM (p =

0.45). The visual analog scale (VAS) for pain with HS on postoperative day 1 was (3.07 ± 2.02

vs. 4.4 ± 2.11 (p = 0.001).

CONCLUSION:

For cirrhotic patients, LC still is more complicated and difficult than for patients without

cirrhosis. The Harmonic scalpel provides complete hemobiliary stasis and is a safe alternative

to the standard clipping of the cystic duct and artery for cirrhotic patients. It offers a shorter

operative duration and less blood loss.

PMID:

20376490

[PubMed - indexed for MEDLINE]

Randomized controlled trial between

perineal and anal repairs of rectocele in

obstructed defecation.

World J Surg. 2010 Apr;34(4):822-9. Farid M, Madbouly KM, Hussein A, Mahdy T, Moneim HA, Omar W.

Source

Department of Surgery, University of Mansoura, Mansoura, Egypt.

Abstract

OBJECTIVE:

The present study was designed to evaluate functional outcome of perineal repair with and

without levatorplasty versus transanal repair of rectocele in obstructed defecation.

METHODS AND PATIENTS:

45

A total of 48 multiparous women with obstructed defecation caused by a rectocele were

randomly allocated to three groups: transperineal repair with levatorplasty (TPR-LP; n = 16);

transperineal repair without levatorplasty (TPR; n = 16); and transanal repair (TAR; n = 16).

The study included defecographic assessment, anal manometry, symptom improvement, sexual

function, and score on a function questionnaire. Assessments were done preoperatively and 6

months postoperatively.

RESULTS:

Defecography showed significant reduction in size of rectocele in all groups. Constipation

improved significantly in both groups with transperineal repair but not in the group with

transanal repair. Significant reductions in mean anal resting pressure, maximum reflex volume,

and urge-to-defecate volume were observed only with the transperineal approach (with and

without levatorplasty). Functional score improved significantly in the transperineal groups

(with levatorplasty, P < 0.001; without levatorplasty, P < 0.01), but not in the transanal group

(P = 0.142). Levatorplasty added to transperineal repair significantly improved the overall

functional score compared with transperineal repair alone (P < 0.01) and transanal repair TAR

(P < 0.001).

CONCLUSIONS:

Rectocele repair appears to improve anorectal function by improving rectal urge sensitivity.

Transperineal repair of rectocele is superior to transanal repair in both structural and functional

outcome. Levatorplasty improves functional outcome, but potential effects on dyspareunia

should be discussed with the patient.

PMID:

20091310

[PubMed - indexed for MEDLINE]

Conventional haemorrhoidectomy, stapled

haemorrhoidectomy, Doppler guided

haemorrhoidectomy artery ligation; post

operative pain and anorectal manometric

assessment.

Hepatogastroenterology. 2009 Jul-Aug;56(93):1010-5. Khafagy W, El Nakeeb A, Fouda E, Omar W, Elhak NG, Farid M, Elshobaky M.

Source

Colorectal Surgical Unit, Mansoura University Hospitals, Egypt. wkhafagy@mans.edu.eg

Abstract

BACKGROUND/AIMS:

The aim of the present article was to compare stapled haemorrhoidectomy, and haemorrhoidal

artery ligation with open haemorrhoidectomy with respect to the postoperative pain, symptom

46

control, and manometric alterations.

METHODOLOGY:

Forty five patients with third or fourth-degree haemorrhoids were randomly classified into three

groups; first group managed by stapled haemorrhoidectomy, second group managed by

conventional haemorrhoidectomy and third group managed by Doppler guided haemorrhoidal

artery ligation. (15 patients each) Preoperative and 12 weeks postoperative anorectal

manometry were done for all patients.

RESULTS:

There was a significant difference of the operative time between stapled group and Milligan-

Morgan group (p < 0.001) while no significant difference between stapled group and Doppler

group. The pain scores were significantly higher in open group (p < 0.001) during the first 24

hours at the time of first motion and one week after operation. Postoperative control of

prolapsed symptoms was significantly better with open diathermy haemorrhoidectomy than

with stapled. The control of other symptoms was similar with regard to bleeding, pain, pruritus,

and incontinence scores. Anorectal manometry showed a decrease in the maximum resting

pressure and maximum squeeze pressure in all groups, but this decrease was only significant in

the stapled haemorrhoidectomy group.

CONCLUSIONS:

Stapled and Doppler haemorrhoidectomy is as effective as conventional haemorrhoidectomy

for the treatment of haemorrhoids, but with the exception of skin tag prolapse. There is a need

for long-term follow-up for the changes in manometric parameters after haemorrhoidectomy.

PMID:

19760931

[PubMed - indexed for MEDLINE]

Utility of serum preoperative

carcinoemberyonic antigen in colorectal

cancer patients.

Hepatogastroenterology. 2009 Mar-Apr;56(90):361-6. El-Awady S, Lithy R, Morshed M, Khafagy W, Abd Monem H, Waleed O, Badr S, Fekry A, El

Nakeeb A, Ghazy H, El Yamany M, Metwally T, El-Arman M, Farid M.

Source

Department of Surgery, Mansoura University, Egypt. elawadysaleh@yahoo.com

Abstract

BACKGROUND/AIMS:

The usefulness of preoperative CEA in CRC remains controversial as regards its biological

function, and its use in the diagnosis, prognosis, and management and follow up of CRC

patients. the aim of this study was to provide a critical and updated study for the value of CEA

47

in CRC.

METHODOLOGY:

From January 2000 to June 2005, a prospective randomized study involving 200 CRC patients

for whom curative resection was performed, another 100 healthy persons as a control group

was included. Basal CEA using chemilumescence technique and routine follow up were done.

RESULTS:

(1) The mean basal CEA in CRC patients (17.3 ng% +/- 1.67) was significantly higher than

control (3.41 ng% +/- 1.1). (2) A significant linear association between basal CEA and Dukes'

classes was evident with the mean basal CEA for Dukes' A, B, C were 7.8, 12.7, 25.8

respectively (expressed as ng%). (3) The validity of basal CEA in primary CRC diagnosis was

highly positive (sensitivity 80%--PPV 86.95%--accuracy 73.66%), with hig her efficacy in

advanced disease detection (sensitivity 93%--NPV 7%--accuracy 84.5%--odds ratio 30.3) and

negative exclusion power for DFS prediction (specificity 13.84%). (4) The basal CEA was a

discriminate factor in colorectal prognosis - B value (3.74). (5) Patients with CEA < or =5 ng%

had better DFS (15%) and DFT (23.6 months) than those with CEA > 5 ng% as they had DFS

(33.75%) and DFT (18.48 months). (6) Basal CEA above 15 ng% had a significant shift in the

cumulative hazard of recurrence.

CONCLUSION:

The CEA is a metastasis potentiator. The high serum CEA in CRC screening programs should

be considered a marker of malignancy especially in patients with appropriate symptoms. The

preop CEA in CRC patients identifies subsets with favorable, indolent and uneven biological

behavior (< or =5 ng%, < or =15 ng%, > 15 ng% respectively). Moreover, the addition of preop

CEA level to conventional staging forms a strong prognostic tool and supplies adopted practice

guideline initiative for follow up and therapy in CRC.

PMID:

19579599

[PubMed - indexed for MEDLINE]

Idiopathic hypertensive anal canal: a place

of internal sphincterotomy.

J Gastrointest Surg. 2009 Sep;13(9):1607-13. Epub 2009 Jun 11. Farid M, El Nakeeb A, Youssef M, Omar W, Fouda E, Youssef T, Thabet W, Elmoneum HA,

Khafagy W.

Source

Mansoura University Hospital, Mansoura, Egypt.

Abstract

BACKGROUND:

Hypertensive anal canal is frequently known to be associated with the presence of anal fissure.

Based on clinical experience, we hypothesized that idiopathic anal sphincter hypertonia was a

48

condition equivalent to anal fissure, and therefore, it could be treated the same way.

PATIENT AND METHODS:

Sixty-three patients complaining of anal pain without any anal pathology and ten healthy

volunteers were examined. All patients underwent clinical evaluation, neurological

examination, anorectal manometry, and measurement of pudendal nerve terminal motor

latency. All patients with hypertensive anal canal were randomized into three groups. Group I

(surgical group) underwent closed lateral sphincterotomy (LS), group II using nitroglycerine

ointment (GTN), and group III received injection of botulinum toxin in internal sphincter. Post-

procedures data were recorded at follow-up period.

RESULTS:

The mean resting anal pressure (MRAP) was significantly higher in the patient group (114.6 +/-

7.4 mmHg) than control group (72.5 +/- 6.6 mmHg, P < 0.001). Anal pain is the main

presenting symptoms aggravated by defecation and not relived by analgesics or local

anesthetics. After LS, pain visual analogue scale decreased significantly at follow-up period

than after chemical sphincterotomy using GTN or BTX (P = 0.001). There was a significant

decrease in MRAP postoperatively from 114.6 +/- 7.4 to 70.8 +/- 5.5 mmHg than after using

GTN or BTX (P = 0.03).

CONCLUSION:

Idiopathic hypertensive anal canal is a fact and already exists presented by anal pain aggravated

by defecation. It can be managed safely by closed lateral sphincterotomy, but chemical

sphincterotomy had a minor role in its management.

PMID:

19517198

[PubMed - indexed for MEDLINE]

Early oral feeding in patients undergoing

elective colonic anastomosis.

Int J Surg. 2009 Jun;7(3):206-9. Epub 2009 Mar 28. El Nakeeb A, Fikry A, El Metwally T, Fouda E, Youssef M, Ghazy H, Badr S, Khafagy W,

Farid M.

Source

Mansoura University Hospital, General Surgery Department, Mansoura, Egypt.

elnakeebayman@yahoo.com

Abstract

BACKGROUND:

This study assesses the safety outcome of early oral feeding and reports on the factors affecting

early postoperative feeding after colorectal procedures.

PATIENTS AND METHODS:

49

Between June 2005 and April 2008, 120 consecutive patients underwent elective colonic

anastomosis and were then randomized into two groups. The early feeding group began fluids

on the first postoperative day while the regular feeding group was managed in the traditional

way - nothing by mouth until the resolution of ileus.

RESULTS:

The majority of patients (75%) tolerated the early feeding. The times to first passage of flatus

(3.3+/-0.9 days vs 4.2+/-1.2 days) and stool (4.1+/-1.2 days vs 4.9+/-1.2 days) were

significantly quicker in group 1. Hospital stay was also significantly shorter in the early feeding

group (6.2+/-0.2 days vs 6.9+/-0.5 days). Operative time and amount of blood loss had an

impact on the tolerability of early feeding while age, gender, type of operation and previous

abdominal operation had no such impact.

CONCLUSION:

Early oral feeding after colorectal surgery is safe and tolerated by the majority of patients.

Operative time and amount of blood loss do, however, have an impact on the tolerability of

early feeding.

PMID:

19332156

[PubMed - indexed for MEDLINE]

Effect of Helicobacter pylori eradication on

ulcer recurrence after simple closure of

perforated duodenal ulcer.

Int J Surg. 2009 Apr;7(2):126-9. Epub 2008 Dec 6. El-Nakeeb A, Fikry A, Abd El-Hamed TM, Fouda el Y, El Awady S, Youssef T, Sherief D,

Farid M.

Source

Mansoura University Hospital, General Surgery Department, Dep. 8, Egypt.

elnakeebayman@yahoo.com

Abstract

BACKGROUND:

This study was conducted to elucidate the prevalence of Helicobacter pylori in patients with a

perforated duodenal ulcer and to determine whether eradication of H. pylori prevent ulcer

recurrence following simple repair of the perforation.

PATIENTS AND METHOD:

Eighty-three patients with perforated duodenal ulcer (68 males); mean age was 47.8 years+/-

7.2. Antral mucosal biopsies (to determine the status of HP by rapid urease test, culture and

histological examination/staining) were obtained during laparotomy by passing a biopsy

forceps through the perforation site. H. pylori positive patients who had undergone patch repair

51

were randomized into the eradication group who received amoxicillin, metranidazole plus

omperazole and the control group was given omeprazole alone. Follow-up endoscopy and

antral biopsies were performed at 8 weeks, 16 weeks and 1 year to show ulcer healing and

determine H. pylori state.

RESULTS:

Of 77 patients in the study, 65 patients (84.8%) had H. pylori. These patients were randomly

divided into the triple therapy group (34 patients) and the control group (31 patients).

Eradication of H. pylori was significantly higher in the triple therapy group than the control

group and initial ulcer healing was significantly better in the eradication group. After 1 year,

ulcer recurrence was (6.1%) in the eradication group vs. (29.6%) in the control group

(P=0.001).

CONCLUSION:

H. pylori was present in a high proportion of patients with duodenal ulcer perforation.

Eradication of H. pylori after simple closure of a perforated duodenal ulcer reduced the

incidence of recurrent ulcer.

PMID:

19138577

[PubMed - indexed for MEDLINE]

Comparative study between botulinum toxin

injection and partial division of puborectalis

for treating anismus.

Int J Colorectal Dis. 2009 Mar;24(3):327-34. Epub 2008 Nov 29. Farid M, Youssef T, Mahdy T, Omar W, Moneim HA, El Nakeeb A, Youssef M.

Source

Mansoura Faculty of Medicine, Mansoura, Egypt.

Abstract

OBJECTIVES:

The objective of this study was to compare the results of partial division of puborectalis

(PDPR) versus local botulinum toxin type A (BTX-A) injection in treating patients with

anismus.

PATIENTS AND METHODS:

This prospective randomized study included 30 male patients suffering from anismus.

Diagnosis was made by clinical examination, barium enema, colonoscopy, colonic transit time,

anorectal manometry, balloon expulsion test, defecography, and electromyography. Patients

were randomized into: group I which included 15 patients who were injected with BTX-A and

group II which included 15 patients who underwent bilateral PDPR. Follow-up was conducted

for about 1 year. Improvement was considered when patients returned to their normal habits.

51

RESULTS:

BTX-A injection achieved initial success in 13 patients (86.7%). However, long-term success

persisted only in six patients (40%). This was in contrast to PDPR which achieved initial

success in all patients (100%) with a long-term success in ten patients (66.6%). Recurrence was

observed in seven patients (53.8%) and five patients (33.4%) following BTX-A injection and

PDPR, respectively. Minor degrees of incontinence were confronted in two patients (13.3%)

following PDPR.

CONCLUSION:

BTX-A injection seems to be successful for temporary treatment of anismus.

PMID:

19039596

[PubMed - indexed for MEDLINE]

Laparoscopic versus open cholecystectomy

in cirrhotic patients: a prospective

randomized study.

Int J Surg. 2009 Feb;7(1):66-9. Epub 2008 Oct 26. El-Awadi S, El-Nakeeb A, Youssef T, Fikry A, Abd El-Hamed TM, Ghazy H, Foda E, Farid

M.

Source

Mansoura Faculty of Medicine, Department of General Surgery, Mansoura University Hospital,

Mansoura, Egypt.

Abstract

BACKGROUND:

Improved laparoscopic experience and techniques have made laparoscopic cholecystectomy

(LC) feasible options in cirrhotic patients. This study was designed to compare the risk and

benefits of open cholecystectomy (OC) versus LC in compensated cirrhosis.

METHOD:

A randomized prospective study, in the period from October 2002 till December 2006, where

110 cirrhotic patients with symptomatic gallstone were randomly divided into OC group (55

patients) and LC group (55 patients).

RESULTS:

There was no operative mortality. In LC group 4 (7.33%) patients were converted to OC. Mean

surgical time was significantly longer in OC group than LC group (96.13+17.35 min versus

76.13+15.12) P<0.05, associated with significantly higher intraoperative bleeding in OC group

(P<0.01), necessitating blood transfusions to 7 (12.72%) patients in OC group. The time to

52

resume diet was 18.36+8.18 h in LC group which is significantly earlier than in OC group

47.84+14.6h P<0.005. Hospital stay was significantly longer in OC group than LC group

(6+1.74 days versus 1.87+1.11 days) P<0.01 with low postoperative morbidity.

CONCLUSION:

LC in cirrhotics is still complicated and highly difficult which associates with significant

morbidity compared with that of patients without cirrhosis. However, it offers lower morbidity,

shorter operative time; early resume dieting with less need for blood transfusion and reducing

hospital stay than OC.

PMID:

19028148

[PubMed - indexed for MEDLINE]

Comparative study between biofeedback

retraining and botulinum neurotoxin in the

treatment of anismus patients.

Int J Colorectal Dis. 2009 Jan;24(1):115-20. Epub 2008 Aug 22. Farid M, El Monem HA, Omar W, El Nakeeb A, Fikry A, Youssef T, Yousef M, Ghazy H,

Fouda E, El Metwally T, Khafagy W, Ahmed S, El Awady S, Morshed M, El Lithy R.

Source

General Surgery Department, Dep. 8 and Colorectal Unit, Mansoura University Hospital,

Mansoura, Egypt.

Abstract

PURPOSE:

Anismus is a significant cause of chronic constipation. This study came to revive the results of

BFB training and BTX-A injection in the treatment of anismus patients.

MATERIALS AND METHODS:

Forty-eight patients with anismus (33 women; mean age 39.6 +/- 15.9) were included in this

study. All patients fulfilled Rome II criteria for functional constipation. All patients underwent

anorectal manometry, balloon expulsion test, defecography, and electromyography (EMG)

activity of the EAS. All patients had non-relaxing puborectalis muscle. The patients were

randomized into two groups. Group I patients received biofeedback therapy, two times per

week for about 1 month. Group II patients were injected with BTX-A. Follow-up was

conducted weekly in the first month then monthly for about 1 year.

RESULTS:

In the BFB training group, three patients quit before the end of sessions with no improvement;

initial improvement was recorded in 12 patients (50%) while long-term success was recorded in

six patients (25%). In the BTX-A group, clinical improvement was recorded in 17 patients

(70.83%), but the improvement persisted only in eight patients (33.3%). There is a significant

53

difference between BTX-A group and BFB group regarding the initial success, but this

significant difference disappeared at the end of follow-up. Manometric relaxation was achieved

significantly post-BFB and post-BTX-A injection with no significant difference between the

two groups.

CONCLUSIONS:

Biofeedback training has a limited therapeutic effect on patients suffering from anismus. BTX-

A injection seems to be successful for temporary treatment of anismus.

PMID:

18719924

[PubMed - indexed for MEDLINE]

American Journal of Medicine and Medical Sciences p-ISSN: 2165-901X e-ISSN: 2165-9036

1122 ;2(2 :)7-21

doi: 10.5923/j.ajmms.20110101.02

Pro-Angiogenic Mediators as Targets for

Chemotherapy of Colorectal Carcinoma

Abstract

Reference

Full-Text PDF

Full-Text HTML

N. M. Abdel-Hamid 1, M. Farid 2, A. Eldemeri 3, M. Atwa 4,

N. Anbar 5

2Nabil Mohie Abdel-Hamid, Departments of Biochemistry, College of Pharmacy, Minia

University

1Mohamed Farid, General Surgery

3Ahmed Hasan Eldemiri, Medical Oncology

1Mohamed Atwa, Clinical Pathology, Faculty of 2,3,4 Medicine

5Nahla Hamed Anbar, Emergency Hospital, Mansoura University, Egypt

Correspondence to: N. M. Abdel-Hamid , Nabil Mohie Abdel-Hamid, Departments of

Biochemistry, College of Pharmacy, Minia University.

Email :

Copyright © 2012 Scientific & Academic Publishing. All Rights Reserved.

Abstract

Purpose Angiogenesis and chronic inflammation are codependent in pathogenesis of colorectal

carcinoma (CRC). We aim to assess whether vascular endothelial growth factor (VEGF), nitric

54

oxide (NO) and total lipase (TL) activity being contributors to angiogenesis, are targets for

CRC chemotherapy. Methods we enrolled 60 subjects, 20 volunteers (10 males and 10 females)

were assigned as control (group I). Forty CRC patients, 20 locally advanced (group II),

subjected to surgery and chemotherapy (5-fluorouracil (5-FU, 425 mg/m2) plus leucovorin

(LV, 20 mg/m2), IV, daily for 5 consecutive days, repeated every 3 to 5 weeks for 6 courses).

The other 20 patients, were metastatic, (group III), followed up, given only adjuvant

chemotherapy. Results Serum carcino embryonic antigen (CEA), cancer antigen (CA19.9),

VEGF, NO concentrations and TL activity were significantly elevated in CRC compared to

control and in Gp III compared to Gp II patients, but were down-regulated by chemotherapy.

VEGF, NO and TL helped in diagnosis and follow up of CRC, although they were not returned

to reference intervals. In conclusion, the response to chemotherapy of VEGF, NO and TL

substantiates an anti-angiogenic potential in controlling CRC. AFP level was not changed in

secondary metastatic hepatocellular carcinoma (HCC), seemingly, it rises only in primary

HCCs.

Keywords: Angiogenesis, Chemotherapy, CRC, Metastasis, NO, Total lipase, VEGF

Cite this paper: N. M. Abdel-Hamid , M. Farid , A. Eldemeri , M. Atwa , N. Anbar , "Pro-

Angiogenic Mediators as Targets for Chemotherapy of Colorectal Carcinoma", American

Journal of Medicine and Medical Sciences, Vol. 1 No. 1, 2011, pp. 7-14. doi:

10.5923/j.ajmms.20110101.02. Article Outline

2 .Introduction

1 .Materials and methods

1.2 .Patients

1.1 .Methods

1.3 .Statistical analysis

1.1 .Ethical approval

1.5 .Results

3 .Discussion

1 .Conclusions

ACKNOWLEDGEMENTS

2 .Introduction

Colorectal cancer (CRC) is one of the major causes of cancer death worldwide, accounting for

more than 150000 new cases, 55000 deaths in the United States and more than100000

mortalities per year in Europe. The incidence of CRC in Egypt ranges from 2 to 6%[1].There is

an increasing risk among those who have first degree relatives with CRC, constituting up to

20% of all patients with CRC[2].The degree of personal risk relates to family history and age of

affected relatives[3]. Increased age was associated with increased risk of advanced colonic

neoplasia[4]. Moreover, excessive weight and abdominal obesity were found to be risk

indicators in men and women[5]. Generally, women have more favorable prognosis than men.

The relation between gender and survival from CRC was complex and appeared to be related to

55

differences in tumor stage and therapeutic modality[6].Treatment of CRC is greatly dependent

on onset and stage of the disease. It always ranges from (1) surgical management by removal of

the primarytumor with adequate safety margin, (2) treatment of the draining lymphatics, and

(3) restoration of function. Appropriate adjuvant therapies can enhance local control, reduce

systemic recurrence and increase organ preservation[7]. Approximately 6% to 10% of rectal

cancers are locally advanced and require extensive surgery for complete tumor extirpation[8.]

Chemotherapy is usually prescribed to eradicate micrometastasis sensitive to cytotoxic therapy.

The standard treatment of metastatic colorectal cancer is a combination of 5-fluorouracil/folinic

acid with irinotecan or oxaliplatin-based chemotherapy. 5-flourouracil (5-FU) is given to

patients with Dukes B, C stage in combination with radiotherapy to secure local recurrence and

distant metastasis[9]. Metastasis of CRC to other extracolonic organs, especially liver is always

faced among patients with long standing disease. Diagnosis of metastasis is made by both

histological and serological investigations. Alpha fetoprotein (AFP) is always used to pursue or

exclude hepatic metastasis. AFP is a normal fetal serum protein synthesized by the liver, yolk

sac and falls to an undetectable level after birth. The primary malignancies associated with AFP

elevations are HCC, linked with chronic infections as hepatitis B and C viruses and with

cirrhosis from various causes. AFP elevation is common in Africa, where HCC is endemic, and

is useful in screening purposes. It can be used to determine the most appropriate treatment for

liver cancer and to follow patients after curative surgery or other treatment[10]. AFP is elevated

in testicular germ cell tumors containing embryonal or endodermal sinus elements. It is a

definitive positive marker in indicating relapse or response to treatment[11]. Tumor

angiogenesis is the proliferation of a network of blood vessels that penetrate into cancerous

growths, supplying nutrients, oxygen and removing waste products. It starts concomitantly with

cancerous tumor cells sending signals to surrounding normal host tissue. This signaling

activates certain genes in host tissue, in turn, make proteins to encourage growth of new

vessels[12.]

However, controllable angiogenesis occurs in healthy body for healing wounds and restoring

blood flow to tissues after injury. In females, angiogenesis also occurs during the monthly

reproductive cycle to rebuild the uterus lining, to mature the egg during ovulation and during

pregnancy to build placenta, favoring maternal- fetal circulation[13]. Trials to inhibit

angiogenesis as means of controlling growth and spread of cancer cells began before 39 yr

ago[14]. Numerous angiogenic growth factors were targeted with modern drugs and have been

identified in large bowel tumors. These included, vascular endothelial growth factor (VEGF),

platelet-derived endothelial cell growth factor (PD-ECGF), basic fibroblast growth factor

(bFGF), platelet-derived growth factor (PDGF), insulin-like growth factors (IGFs), angiogenin,

thrombospondin, angiopoeitins, and integrins [15.]

Binding to VEGF receptor-2 (VEGFR-2) starts a tyrosine kinase signaling cascade that

stimulates NO expression[16]. Inducible nitric oxide synthase (iNOS) is an enzyme catalyzes

NO production, found to be over-expressed in chronic inflammatory diseases and various types

of cancer[17]. NO is an important regulatory molecule in inflammatory response, cancer

development and endogenous mutagenenesis[18,19], angiogenic factor[20], an enhancer of

protooncogene expression[21,22] and an inhibitor of apoptosis[23]. Lipase is a water-soluble

enzyme that catalyzes the hydrolysis of ester bonds in water insoluble, lipid substrates[24]. It

exerts dual functionality: anti-inflammatory, through enhancing remnant lipoprotein catabolism

and pro-inflammatory through alteration in lipid metabolism and induction of inflammatory

cytokines[25]. It was implicated in colorectal carcinogenesis, being engaged in mucosal lipid

metabolism. Thus, lipase activity was reported to be increased in the colorectal mucosa

affecting lipid metabolism within the tumor tissue[26]. Angiogenesis is a target of some new

drugs used as adjuvant for chemotherapy. These drugs may be expensive, or in many

developing countries, not yet utilized, and conventional chemotherapies still the cornerstone in

cancer management in public hospitals. Most studies on angiogenesis relied on VEGF. NO and

lipase are always missing among angiogenic stimulators in most -if not all- studies on

angiogenesis inhibition.

The present work aimed at studying the contribution of angiogenesis in CRC pathogenesis,

56

recurrence and metastasis among groups from Mansura city, staged according to Duke’s

principle. In addition, exploring a possible effect of common chemotherapy on angiogenesis,

depending on three relevant parameters, serum VEGF and NO and total lipase levels (TL), to

monitor CRC progression along with carcinoembryonic antigen (CEA), carbohydrate

(carcinogenic) antigen (CA 19.9) and AFP serum levels as diagnostic and prognosticators.

Tissue samples from both colon and liver were examined before surgical intervention for

cancer staging.

1 .Materials and methods

1.2 .Patients

This study was carried on 60 subjects; 40 patients with histopathologically confirmed CRC

(classified into 2 groups, 20 patients (stages B & C) according to Dukes' staging[27], 11 males

and 9 females of age range 41.2 ± 12.9 years (mean ± SD, assigned as locally advanced CRC

(Group II). Patients of this group were subjected to elective surgery and adjuvant

chemotherapy. The third group, assigned as metastatic (group III), consisted of 20 CRC

patients of stage D, 10 males and 10 females, their mean age was 48.3 ± 11.2 years, patients of

this group were followed up and given only adjuvant chemotherapy, adapted according to

Mayo Clinic regime (5-fluorouracil, 425 mg/m2 plus leucovorin 20 mg/m2, by rapid IV bolus,

daily for 5 consecutive days every 3 to 4 weeks , repeated for 6 courses[28]. Body surface area

(BSA) in m2 was calculated from the following formula: BSA = (W 0.425 x H 0.725) x 0.007184.

(W) represents weight in kilograms and (H), height in centimeters[29,30].The studied

parameters were compared to that of normal control (group I), consisted of 20 volunteers (10

males and 10 females, of mean age, 49.4±18.2 years, from volunteer nursing staff), at Surgery

and Nuclear Medicine Departments, Mansoura University Hospitals, Egypt, between January

2007 and January 2009. Written consents were taken from all participants. Thorough history

including age, sex, rectal bleeding, abdominal distention, constipation, special habits, history of

previous colorectal disease or surgery, clinical examination and manifestations of intestinal

obstruction, general, abdomino-pelvic and rectal examination were done. Barium enema,

abdominal ultrasound and preoperative colonoscopy, biopsy for histological examination were

achieved for differential diagnosis and Dukes' staging, were conducted. These information were

archived in patient files at the Department Registration Office. Among the studied CRC groups,

male to female ratio was 54.3% / 45.7%. Fasting blood samples were withdrawn from patients

and control, separated sera were kept for assays. Participated patients shown as post-treatment

subjects, others, changed setting of follow-up. Figures show the clinical findings of presented

cases, (Figure 1-3), in addition to histological examination of both colon and liver of the

selected groups before surgical intervention (Figure 4:)

1.1 .Methods

Histological examination of pre-operative tissue samples were done after hematoxylin and

eosin (H&E) staining. Serum CEA and CA19.9 were determined by automatic Roche Elecsys

2010, Switzerland, based on electrochemically generated chemiluminiscence[31]. AFP was

determined by Sandwich ELISA, Boehringer, Germany[32]. Serum VEGF level was made by

Sandwich enzyme immunoassay technique (R & D Systems Inc., MN, USA) according to the

method of Sheng et al.[33]. Nitric Oxide (NO) was assayed by colorimetric method using kit

group of Oxis International Inc, Portland, OR, USA, according to the method of Miranda et.

al,[34]. Serum total lipase activity was determined by kits purchased from Genzyme

Diagnostic, Inc, Canada and the manufacturer's instructions were followed. Figure 1. Clinical data of CRC patients. Numbers of recruited patients (Proximal colon:

10, Distal colon:15, Rectum:15), percentages are among each group . Figure 2. Pathological forms among CRC patients.

57

Figure 3. Duckes stages of CRC patients.

Figure 4. Histological staging of CRC patients, showing both locally advanced and

metastatic invasion among studied cases.

1.3 .Statistical analysis

The data were expressed as mean ± SD. Statistical significance was examined by one-way

analysis of variance (ANOVA) using SPSS program. P values less than 0.05 were assumed to

be statistically significant.

1.1 .Ethical approval

Ethical approval for the study was obtained from Mansura University Research Ethics

Committee.

Table 1. Serum levels of CEA, CA 19.9 and AFP in CRC patients, pre and post chemotherapy,

compared to control (Values are expressed as Mean ± SD)

Group CEA (ng/dl) CA 19.9 (ng/dl) AFP (ng/ml)

Control subjects (n = 20) 1.11±1.17 6.8±1.12 5..3±1.81

CRC Patients (n = 40). (Data of both groups before treatment are pooled) 11.71±**3.81

31.1±**1.51 7.31±1.57

Pretreated group II (n = 20) 31.71±**3..1 13.15±**1.13 7.78±1.81

Pretreated group III (n = 20) 16.31±**&8.17 36.31±&**3..3 7.81±1...

Post-treated group II (n= 20) 21.17±&&2.78 23.57±&&2.55 7.16±1.72

Post-treated group III (n=20) 18.15$±#1.77 1...5±1.13$$ 7.28±1..5

Table 2. Serum levels of VEGF, NO and TL activity in CRC patients, pre and post

chemotherapy, compared to control (Values are expressed as Mean ± SD.)

Group VEGF (pg/ml) NO (μmol/l) Total lipase (U/l)

Control subjects (n = 20) 28..55±21 7.25±1.37 33.53±2.55

CRC Patients(n=40)(Data of both groups before treatment are pooled) 821..1±**52.16

26.18±**2.23 11.87±1.12**

Pretreated group II (n = 20) 178.17±**15.76 28..7±**2.75 11.12±2.61**

Pretreated group III (n = 20) 7.1.33±&**62.6. 2...7±&**2.1 11.62±3.61&&**

Post-treated group II (n= 20) 111.76±&&12.22 21..3±&1..7 37.1.±2.7.&&**

Post-treated group III (n=20) 1...61±17.51$$# 21.82±2.61$# 31.18±1.13##

In Tables1, 2: ** Highly significant increase (P < 0.01) when compared to control subjects.

&Significant increase (P < 0.05) when compared to pretreated group II patients.

&&Highly significant decrease (P < 0.001) when compared to pretreated group II.

#Significant decrease (P < 0.05) when compared to pretreated group III patients.

##Highly significant decrease (P < 0.001) when compared to pretreated group III patients.

$ Significant increase (P < 0.05) when compared to post-treated group II patients.

$$ Highly significant increase when compared to post-treated group II (P < 0.001.)

1.5 .Results

Histological examination showed malignant alterations in colon tissue and graded as B1 (lymph

node) and C (muscular) infiltration, being locally advanced, while graded D patients showed

metastatic liver cancer (Figure. 4.)

Serum levels of CEA and CA 19.9 were significantly higher among CRC patients, higher

values in group III rather than group II individuals. These parameters were significantly

depressed after treatment in both groups II and III although a failure to reach normal control

values is seen. AFP values in CRC groups were ns elevated than control values, chemotherapy

also ns depressed its values (Table1). Both VEGF, NO and TL were significantly elevated in

CRC individuals than normal control. The three parameters were significantly higher in

metastatic than locally advanced CRC individuals and healthy controls. Chemotherapy

58

although significantly decreased theses parameters, only TL activity was near to normal in

metastatic individuals, while both VEGF and NO were not(Table 2.)

3 .Discussion

Angiogenesis is a pre-requisite for tumor growth and metastasis. Development of cancer

consists of multiple, sequential and interrelated steps that lead to generation of autonomous

clone with aggressive growth potential. Then, the stroma must be vascularized to support

continued growth and spread[35]. VEGF expression is significantly correlated with lymph node

metastasis and clinical stages of CRC[36]. Extensive studies on inhibition of angiogenesis as a

new way to inhibit cancer, are going on. Bevacizumab (a new monoclonal antibody against

VEGF) was selectively used, combined with common chemotherapeutic protocols, this greatly

increased survival rates and improved outcomes[37,38.] In the present work, CEA and CA19.9 were used as biochemical markers for judging CRC,

AFP for judging liver cancer metastasis in addition to demographic, endoscopic, histological

data (Figure. 1-4). These tumor markers were significantly higher in all CRC samples, showing

higher elevations in metastatic subjects. These results are in agreement with that of Wang et

al.[39], who reported that CEA is associated to gastrointestinal cancer, produced abundantly in

CRC tissues. Increased CEA level in group III rather than II is in accordance with some

previous observations[39,40,41], noticed that CEA level is increased with stage and metastasis

of tumor. CEA is expressed in normal mucosal cells and over-expressed in adenocarcinoma,

especially CRC[42]. Elevated CA19.9 is in agreement with results reported by Duffy et al.[43],

who reported that it is frequently increased in sera of patients with colorectal cancer. Increased

CA19.9 level with tumor stage is also in agreement with results of Grotowski et al.[41],Wang

et al.[44], who reported that CA19.9 level and sensitivity are increased with increasing Duke’s

stage. 5-FU/LV significantly down-regulated CEA and CA19.9 in locally advanced and metastatic

patients than pretreatment values. Although these figures couldn’t be restored to normal CRC-

free values, clinical status of patients was moderately improved. These results were previously

registered by Gholam and co-authors[45].AFP didn't show significant variations in all studied

subjects in comparison to control healthy group. This possibly means that AFP appears only

after longer period of metastasis into liver from an extrahepatic donor organ and that the

examined patients haven't AFP colon cancer producers[46]. VEGF is the most important

cytokine involved in neo-angiogenesis which is of crucial importance for CRC[47]. It has been

demonstrated that increased vessel counts in tumors are associated with higher risk of

metastasis in various types of cancers, including CRC[48.] In our study, VEGF was significantly higher in all CRC samples, showing more significant

elevations in metastasis (group III than group II) patients. These results indicate that VEGF

expression is increased with advancing Duke’s stages, coincided with Galizia et al.[49]. Lee et

al.[50] added that, VEGF expression was increased with progression of CRC stages and

patients with highest VEGF expression had significantly poorer prognosis, earlier recurrence

and death than those with lower levels. The high VEGF expression, correlated with Duke’s

stages and presence of distant metastasis could be explained by high molecular alterations in

advanced CRC[51.] 5-FU/LV significantly decreased VEGF levels in locally advanced and metastatic groups.

Actually, studies of the impact of 5-FU/LV on VEGF levels were very sparse. Most studies in

this respect relied on clinical symptoms relevant to angiogenesis without evaluation of this pro-

angiogenic factor. Some studies tried bivacizumab with 5-FU/LV to pursue antiangiogenic

potential of this new drug, without assessing VEGF values[52]. Additionally, in vitro studies

showed that 5-FU based drugs, given alone, could inhibit angiogenesis[53,54]. Inversely, low

doses of 5-FU stimulated angiogenesis, meaning that only cytotoxic doses can inhibit

angiogenesis[55.] On the other hand, inducible NO(iNOS) has been elevated in gastric metaplasia[56], chronic

gastritis[57], hepatocytes in viral hepatitis[58], cholangiocytes in primary sclerosing

59

cholangitis[59] and colonocytes in inflammatory bowel disease[60]. Production of NO may

promote tumor growth by stimulating angiogenesis[61], increasing vascular permeability and

suppressing the immune response[62]. Our study showed a highly significant increase in serum

NO level in CRC patients, group II and III than control. Fantapie et al.[63] reported that NO

was over-expressed in tumor tissue compared to normal mucosa of CRC patients. Hao et al.[64]

registered that iNOS level was increased in the tumor tissue two-folds when compared to

normal colon mucosa. Our results revealed more significant increase in serum NO level in

those with metastasis when compared to pretreated group II patients. This result agreed with

that of Jenkins and colleagues[20], who reported that iNOS levels were higher in tumor

specimens with lymph node or distant metastasis than those without metastasis. It was

suggested that NO may be regarded as a novel biological marker in cancer prognosis[65]. Both

total NO expression and iNOS activity were reported to promote tumor progression and might

explain the association between NO and tumor staging[66]. Additionally, expression of iNOS is

one of the potential mechanisms by which NO can promote tumor growth and metastasis, being

an important stimulant of angiogenesis[67]. In the present study, total serum lipase activity was

significantly up-regulated among CRC patients, an observation reported elsewhere[68] and

added that this up-regulation was not associated with evidence of pancreatitis. In addition,

metastatic group showed more significant up-regulation of lipase activity. This action is in

agreement with the reported results of Munoz-Perez et al.,[69] who observed an increased

serum lipase in patients with massive abdominal metastases. There are several possible

mechanisms explaining the increase in serum lipase level in CRC patients, such as the presence

of an unusual lipase isoenzyme, a decrease in the clearance or rate of inactivation of lipase in

the circulation, the persistence of lipase in blood after complexation with plasma protein, or the

direct production of lipase from the neoplastic masses[68,70]. In our study, the treatment

significantly decreased lipase activity than pre-treatment values, an indication that lipase

changes are primarily responsive to chemotherapy. Some studies have illustrated that the

autocrine effect of lipase on macrophage activated tumor necrosis factor alpha (TNF-α) and

additional induction on interferon gamma (IFN-γ) results in a well-known synergistic effect of

IFN-γ and TNF-α on macrophage NO production, which suggests the possibility that lipase

may act with IFN-γ to increase macrophage NO formation[71]. Activation of nitric oxide

synthase (NOS) gene expression has been reported to occur after macrophage stimulation with

IFN-γ and lipase[72]. This is why we studied this group of contributing players in CRC

diagnosis and treatment outcomes. On the other hand, because a metastatic group was opted in

the study, AFP levels were checked in all groups. This was done to see if AFP is elevated in

early diagnosed secondary HCC or not. The results revealed that its level was not changed to

significant levels in all studied groups in comparison to normal group. This is possibly due to

the poor sensitivity of AFP in early born HCC, as it is well known that its sensitivity is only

around 60%[73.]

1 .Conclusions

It seems that angiogenesis mediators (VEGF, NO and TL) shared CEA and CA19.9 in both

diagnosis and prognosis of CRC. They were concomitantly elevated in local and metastatic

invasion, with obvious up-regulation in metastasis. However, AFP seems to be not significantly

affected in all groups, considering HCC as a secondary metastatic type after CRC. Response to

chemotherapy was striking in TL rather than VEGF and NO. This substantiates a new role,

which is the anti-proangiogenic potential of common 5-FU/LV protocol as an additional

pathway in controlling CRC in cytotoxic doses. VEGF, NO persistent elevations among

metastatic individuals after adjuvant therapy is an additional tool predicting recurrence, while

TL is not reliable recurrence predictor, as it is affected by chemotherapy, which means that

mostly it may be accommodated and escapes contribution into recurrence. AFP level was not

changed in secondary metastatic hepatocellular carcinoma (HCC), seemingly, it rises only in

primary HCCs The study also necessitates the significance of controlling NO expression and

suppressing inflammation as adjuvant modality in CRC therapeutic strategies and possibly

61

claim for selective angiogenic inhibitors to improve chemotherapy outcomes.

ACKNOWLEDGEMENTS

The histological examinations were done at Histopathology Department at University Hospital

of Mansura University, Egypt, under supervision of Pro Adel A. Zalata, professor of Pathology

at the same Department.

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DOI 10.1007/s11605-012-1984-5 ---------------------------------------------------------------------

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ORIGINAL ARTICLE Comparative Study of Conventional Lateral Internal

Sphincterotomy, V-Y Anoplasty, and Tailored Lateral

Internal Sphincterotomy with V-Y Anoplasty

in the Treatment of Chronic Anal Fissure Alaa Magdy & Ayman El Nakeeb & El Yamani Fouda & Mohamed Youssef & Mohamed Farid

Received: 4 April 2012 / Accepted: 24 July 2012 / Published online: 7 August

2012

# 2012 The Society for Surgery of the Alimentary Tract

Abstract

Background Lateral internal sphincterotomy has been proven highly effective in

curing anal fissure but with a high incidence

of postoperative incontinence.

Objective We compared conventional lateral internal sphincterotomy, V-Y

advancement flap, and combined tailored lateral

internal sphincterotomy with V-Y advancement flap in treating anal fissure.

Patients Consecutive patients treated for anal fissure at our colorectal unit were

evaluated for inclusion. Participants were

randomly allocated to receive conventional sphincterotomy (GI), V-Y

advancement flap (GII), or combined tailored lateral

sphincterotomy with V-Y advancement l flap (GIII).

Main Outcome Measures The primary outcome measure was the incontinence

rate; secondary outcomes included healing

rate, operative time, anal manometery, and recurrence rate.

Results One hundred fifty patients with chronic anal fissure were randomized.

Healing rate after 1 year was 84 % in GI, 48 %

in GII, and 94 % in GIII, respectively (P00.001). The recurrence rate was 4 % in

G1, 22 % in GII, and 2 % in GIII (P00.01).

Incontinence rate was 14 % in GI, 0 % in GII, and 2 % in GIII (P00.03).

Conclusion Although all three procedures are simple and easy to perform, tailored

lateral internal sphincterotomy with V-YF

appears to produce the greatest healing rate, with the fewest complications and

less rate of recurrence.

65

Keywords Anal fissure . Advancement flap . Internal

sphincterotomy

Original research--------------------------------------------------------

----------------------------------------------------------------------------

Contents lists available at SciVerse ScienceDirect International Journal of Surgery

journal homepage: www.theijs.com

Comparative study between Delorme operation with

or without postanal repair and levateroplasty in

treatment of complete rectal prolapse Mohamed Youssef, Waleed Thabet, Ayman El Nakeeb*, Alaa Magdy, Emad Abd

Alla,Mahmoud Abd El Nabeey, El Yamani Fouda, Waleed Omar, Mohamed

Farid

Department of General Surgery e Colorectal Surgery Unit, Mansoura University

Hospital, Mansoura, Egypt

a r t i c l e i n f o

Article history:

Received 18 September 2012

Received in revised form

2 November 2012

Accepted 14 November 2012

Available online xxx

Keywords:

Rectal prolapse

Anal manometery

Levator ani

Delorme

a b s t r a c t

Background: Rectal prolapse is a distressing and socially disabling condition.

controversy exists regarding

the preferred surgical technique for the treatment of complete rectal prolapse.

Objective: We compared Delorme operation alone or with postanal repair and

levatroplasty in treating

complete rectal prolapse.

Methods: Consecutive patients treated for rectal prolapse at our colorectal unit

were evaluated for

inclusion. Participants were randomly allocated to receive Delorme operation

only (GI), or Delorme

operation with postanal repair and levatorplasty (GII).

Main outcome measures: The primary outcome measure was recurrence rate;

secondary outcomes

66

included improvement of constipation, incontinence, operative time, anal

manometery and postoperative

complications.

Results: Eighty-two consecutive patients with rectal prolapse were randomized.

There was a significant

difference between the two groups with longer operative time in group II.

Recurrence rate after one year

was (14.28% in GI, and 2.43% in GII, respectively (P ¼ 0.043). Constipation

improved in group I & II but

there was a significant difference in constipation scores postoperatively between

the two groups. There

was improvement in continence mechanism in both groups postoperatively but

being higher in group II

and this produce a significant statistical difference (0.004). Mean satisfaction

score was significantly

higher in group II than group I. Both groups succeed to produce a significant

change in resting and

squeeze pressure before & after the operation.

Conclusions: Delorme operation seems to be an effective procedure for treating

complete rectal prolapse

especially if combined with postanal repair and levatorplasty.

Clinical trial registration: NCT01656369.

_ 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

1. Introduction Rectal prolapse frequently occurs in older women. The male-tofemale

ratio is 1:6 with a peak incidence between 50 and 60 years

of age.1 Patients usually present with obstructed defecation or fecal

incontinence. Controversy still presents as regards the preferred

surgical procedure for the treatment of rectal prolapse. The transabdominal

procedure is generally considered by some authors

more effective in healthy patients compared to perineal procedures.

2e5

Yakut et al.6 retrospectively reviewed their results for the

Delorme procedure and for abdominal procedures performed for

rectal prolapse and reported that in men, one of the most important

complications was sexual dysfunction secondary to extensive

pelvic dissection and posterior rectopexy procedures, leading to

a recommendation of a perineal approach to rectal prolapse in

young male patients. Interestingly, Oliver et al. found that a general

improvement in continence after Delorme procedure, likely related

to increased bulk provided by the plicated muscularis propria.7

Pescatori et al.8 combined the Delorme procedure with

sphincteroplasty in 33 patients successfully improving the continence

of 70% of the patients and curing constipation in 44%. From

a functional point, 50e75% of patients with rectal prolapse exhibit

fecal incontinence.9e13 This may be due to traumatic stretch injury

67

to the sphincter complex, a finding that has been supported by

endosonography.14e16 Alternatively, continuous stimulation of the

rectoanal inhibitory reflex by the prolapse leads to chronic low

internal anal sphincter pressures.17 Hence came the idea of our

* Corresponding author. Tel.: 20 1006752021.

E-mail address: elnakeebayman@yahoo.com (A. El Nakeeb).

Contents lists available at SciVerse ScienceDirect International Journal of Surgery

journal homepage: www.theijs.com 1743-9191/$ e see front matter _ 2012 Surgical Associates Ltd. Published by

Elsevier Ltd. All rights reserved.

http://dx.doi.org/10.1016/j.ijsu.2012.11.011

International Journal of Surgery xxx (2012) 1e7

THESIS SUPERVISED

1. Superior Vena Cava Obstruction

Done by: Dr. Ehab Mohamed Ali.(MS)

Registerd at: 13/10/1985.

2. Monitoring of The Burned Patients

Done by: Dr. Ahamed Baha Mostafa.(MS)

Registerd at:10/09/1989.

3. Surgically Constructed Pouches in Surgery

Done by: Dr. Hisham Abd El. Menhim.(MS)

Registerd at: 12/11/1989.

4. Non Surgical Mangment of Gall Stones

Done by: Dr. Samir Mohamed Atia . (MS)

68

Registerd at: 09/09/1990.

5. Post Resection Broncho-Pleural Fistula

Done by: Dr. Yasser Ahamed Farg.(MS)

Registerd at:08/09/1990.

6. Surgical Aspects in Diagnosis and Treatment of APUDomas

Done by: Dr. Tarek Ibrahim El - Mahdi. (MS)

Registerd at: 13/12/1992.

7. Surgical Aspects in Diagnosis and Treatment of Suprarenal

Tumour

Done by: Dr. Yasser Ali Ibrahim(MS)

Registerd at: 14/06/1993.

8. Endocrine Therapy of Breast Cancer

Done by: Dr. Waleed Mostafa Omar(MS)

Registerd at: 12/06/1994.

9. Immunological Study Before and after Surgery in Patients with

Malignant Thyroid Tissue.

Done by: Dr. Yasser Ali Ibrahim(MD)

Registerd at: 10/7/1994.

10. Surgical Aspects in Diagnosis and Mangment of Parathyroid Gland

Disorders.

Done by: Dr. Hisham Abd El – Menhim (MD)

Registerd at: 13/08/1995.

11. Surgical Aspects in Mangment of Pituitary Gland Tumour.

Done by: Dr. Tamer Youssef Mohamed Youssef (MS)

Registerd at: 10/12/1995.

12. Gall Bladder Motility in Chronic Cholecystitis (MD)

Done by: Dr. Amr Ahamed Kamal

Registerd at: 23/02/1997.

13. Abdominal Fixation of Rectum in comparison with Perineal

Approach in Surgical Treatment of Rectal Prolapse

Done by: Dr. Ahamed Mohamed El- Refahi (MD)

69

Registerd at: 08/06/1997.

14. Different Surgical Procedures in Mangment of Clinically Sever Obesity

Done by: Dr. Ahamed Abd El- Menhim (MD)

Registerd at: 14/09/1997.

15. Immunological Study of 1ry Toxic Goitre and Chronic Thyroiditis.

Done by: Dr. Tarek Ibrhaim El – Mahde.(MD)

Registerd at: 11/05/1997.

16. A Comparative Study Between Laparoscopic and Conventional

Technique in Ligation of Perforators in Treatment of Varicose Vein of

Lower Limb

Done by: Dr. Abd El-La El-Said Abd El-La.(MS)

Registerd at: 04/06/1998.

17. Different Clinical and Pathological Methods in Diagnosis and

Treatment of Fibrocystic Disease of The Breast and Fibroadenosos

Done by: Dr. Hisham Mohamed Abd El-La (MS)

Registerd at:06/12/1998.

18. Reconstructed Microvascular Flap Anastomosis after Radical Ablation

Of Hypopharangeal Carcinomas

Done by: Dr. Nabeel Rezk (MD)

Registerd at: 1998.

A. Medico-Legal Assessment of Anal Sphincter

Function in Sodomists

Done by: Dr Mohamed El-Gamal.(MS)

Registerd at: 09/09/1999.

20. Gut Ischemia, Oxidative Stress, Bacterial Translocation and

Haemodynamic Changes in Pneumoperitoneum During Laparascopic

Surgery.

Done by: Dr. Waleed Mostafa Omar (MD)

Registerd at: 05/08/1999.

21. Comparitive Study Between Biofeed Back and Surgical Treatment in

Mangment of Fecal Incontinence`

71

Done by: Dr. Waleed Mohamed Thabet (MS)

Registerd at: 04/07/1999.

22. Electro Physiological Nerve Stimulation for Identification of

Recurrent Laryngeal Nerve in Thyroid Surgery

Done by: Dr. Ahamed Lotfy El- Said.(MS)

Registerd at: 04/07/1999.

23. Role of External Beam Irradiation with or without Chemotherapy in

Treatment of Colorectal Cancer

Done by: Dr. Mayy Al Shahat (MD)

Registerd at: 1999.

24. Phenotypic and Genotypic Charecteristic of Nasocomial Locates of

Epidimic with Methcylline Resistant Staph. Aureas in Mansoura

University Hospital.

Done by: Mona Fouda (MD)

Registerd at: 05/12/1999.

25. The Role of Steriotactic Surgery in Treatment of Brain Tumour

Done by: Dr. Samir Nabil Serag (MS)

Registerd at: 09/04/2000.

26. Correlation Between Incontinence Score & Physio Anatomical

Changes Following Posterior and Lateral Sphincterotomy

(Conventional And Tailored) In Treatment of Chronic Anal Fissure

Done by: Dr. Mohamed Youssef Abo El- Kair. (MS)

Registerd at: 2001

27. Ultrasonic Evaluation of Scrotal Swelling

Done by: Dr. Mohamed Ziade(MS)

Registerd at: 1995

28. Rectoanal Advancement Flap Versus Coring Fistulectomy in Manegemnt

of Anal Fistula.

Done by : Dr. Moheab Magdy (MS)

Registerd at: 2003.

71

29. Comparative Study Between Surgical and Non Surgical Treatment

of Anisums in Patients with Symptoms of Obstructed Defecation.

Done by: Dr. Mohamed Youssef Abo El- Kair (MD)

Registerd at: 2003.

30. Transperineal Repair with or without Levatorplasty Versus Transanal

Repair Manual or Stapled for Treatment of Rectocele in Obstructed

Defecation.

Done by: Dr.Waleed Mohamed Thabet (MD)

Registered at:2004.

31. Evaluation of Unilateral Gluteus Maximus Transposition in Treatment

of End Stage Fecal Incontinence .

Done by: Dr. Alaa Magdy (MD)

Registered at : 2005.

32. Assessment of Self Care Practicees Among Adult Colostomy Patients

Done by: Eman Abdel Rahman Mohammed Alhasanin .Faculty of

Nursing(MS)

Registered at : 2005

33.Role of surgery in lesional epilepsy .

Done by Amr F khalil . Registered at :2006 (MS)

34.Evaluation of different treatment modalities in management of anal

fistula. 2004 Mahmoud abd elnaby (MD)

35. Harmonic scalpel vs. closed excisional hemorrhoidectomy .

Done by Emad Abdelfatah.

36. Evaluation of ligh sure (computer guided bipolar diathermy)

hemorrhoidectomy: Prospective study .

Done by Ahmed Ali Eldin Ahmed Ali .(MS)

37. Constipation scores in relation to the the indications and the results of

surgery in obstructed defecatoion .

Sameh Emile Rezkalla (MS).

72

38. Laparoscopic assisted Abdominoperineal Resection for treatment

of cancer lower third rectum : evaluation of the technique and

functional outcome.Don by Hesam Mostafa El- Gendy (MD).

39. Evaluation of Clinical and histopathological features of colorectal

carcinomas below the age of thirty years.

Done by Ahmed Fadaly Hussein Hasanen . (MS)

GLOSSARY WITH BOOKS SCIENTIFIC REFERRENCES AND

RESEARCH PROJECTS :

1- TEXT BOOK 5 VOLUMES AID IN GENERAL SURGERY 2009

1. Screening Program for Colorectal Cancer in Patients with

bilharzial Colitis in Dakahlia(1999-2003).

2. M.C.Q book in General Surgery for undergraduates.

3. Clinical Case Scenario in surgery for undergraduates.

4. Differential Diagnosis in surgery for undergraduates.

73

AWARDS

Great Mind of The 21st Century by the American Biographical Intitute

2007/2008.

Selection for Deputy Director Geneeral of The IBC (2006) .

Selection for American Hall of Fame (May 19, 2006).

Selection for Inaugural World Forum at Oxford University (July 4-9

2006).

Selection for The American Biographical Institute Research

Association (2007).

Award of Mansoura University Prize in Medical Science (2006).

Acknowledged by The Dean of Faculty Of Medicine for The Great

and Distinguished Participation in The Medical Field at The Local ,

National and International Arenas.2006.

Selection for Hon. Director General for Africa of The International

Biographical Centre. Cambridge, England 2006.

Selection for The Da Vinci Diamond for The Advancement in The

Society in Local National and International Arena. November,

2006.

Selection for The World Medal of Freedom. 2006.

Selection for The Gold Medal for The Year 2007.

Great Mind Of The 21st Century by The American Biographical

Institute 2007/2008.

International Professional of The Year 2007 by The American

Biographical Institute.

74

Lifetime Achievement Award of The United Cultural Convention.

2007.

Selection for Man of The Year 2007 by The American

Biographical Institute .

Member in World Record Holder According to American

Biographical Institute , February 23, 2007 .

Rewarded The Egyption Medical Syndicate (Shield and

Appreciation Certificate) for his distinguished efforts in The

Medical Field and Applying Health Care for Citizens.

Acknowledged by The Syndicate on The Doctor Day March 18,

2007 .

* Award of the best pooster &oration in the the sixth biannual congress of

med society of coloproctolgy and Italian society of colorectal surgeons

held in Rome Italy February 1-2, 2008 .Descion for publication in

Technique in coloproctology J by the scientific committee.