Post-Transplant Ureteric Stricture Managed By Extra-Anatomical Stenting With Modification on the Originally Described Stent Location: A Case Report.

Ureteric strictures are a relatively uncommon complication following renal transplant, which may be managed endoscopically or surgically by repairing the stricture. Extra-anatomical bypass is a useful procedure in complex cases that bypasses the ureter by creating a subcutaneous route, although it is uncommonly used given its rare indication. We report a case of renal transplant ureteric stricture, in which we utilized a modified extra-anatomical stenting technique with a Detour® stent to avoid the fibrotic planes surrounding the lateral aspect of the kidney graft.

Clinical outcomes of simultaneous bilateral total knee arthroplasty.: A tertiary-center experience.

OBJECTIVES: To characterize patients who underwent simultaneous bilateral total knee arthroplasty (simBTKA) and study the outcomes of surgery along with complication rates. METHODS: This is a retrospective study carried out at King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. The study included patients who had undergone simultaneous bilateral total knee replacement from January 2010 until June 2021. RESULTS: The median age of our patients was 64 (Q1-Q3: 59-70) years, 76 (13.2%) males and 393 (83.8%) were females. Hypertension was the most common associated comorbidity (56.29%) and primary osteoarthritis was the most common indication of surgery (96.8%). The median duration of surgery was 155 (140-175) minutes and the median duration of hospital stay was 9 (8-11) days. A total of 17 (3.62%) patients needed revision of surgery in a median duration of 265 (112-529) days. The composite endpoint of complications, intensive care unit admission, and blood transfusion occurred in 132 (28.14%) patients. Hospital stay was longer in males (coefficient: 0.11 [0.02-0.19]; p=0.01) and in patients with cardiac (coefficient: 0.12 [0.02-0.21]; p=0.02), and renal diseases (coefficient: 0.23 (0.06-0.39); p=0.01). Cardiac disease was the only factor associated with the composite outcome (odds ratio: 2.25 [1.19-4.24]; p=0.01). CONCLUSION: Our results suggest simBTKA is a safe procedure with a low complication rate. However, male patients and those with cardiac and renal diseases are at increased risk of post-operative complications and prolonged hospital stay.

A pediatric case of double gallbladder with gallstone.

Double gallbladder is a rare anomaly and an asymptomatic condition. However, it can sometimes present with abdominal pain. Gallbladder pathology requires precise diagnosis and a surgical procedure to relieve its symptoms. Here, we discuss a case of a child suffered from a congenital heart disease who presented with double gallbladder having gallstones. The case was resolved via surgical intervention without postoperative complications.

Thyroglossal duct surgery. What is the acceptable recurrence rate?

OBJECTIVES: To present experiences of different specialties in the treatment of thyroglossal duct cysts (TGDCs) and subsequent complications in multiple centers.  Methods: A retrospective cross-sectional study of all cases of TGDC for a period of 11 years from 2008-2019 by different departments from 3 different centers in Jeddah, Kingdom of Saudi Arabia (King Faisal Specialist Hospital and Research Centre, Bakhsh Hospital and International Medical Center). Results: Forty-nine patients were included. The type of surgery performed plays a significant role in recurrence (p less than 0.001). The Sistrunk procedure had a lower recurrence rate (0%) than simple excision (70%) and has showed a significantly long recurrence-free interval (p less than 0.001). Higher recurrence rates are associated with higher postoperative complications (p=0.002). Patients who underwent pre-operative fine needle aspiration did not have any recurrence during the follow-up period. Conclusion: The Sistrunk procedure is the gold standard technique with the highest recurrence-free interval rate. Fine needle aspiration could be recommended as a less invasive procedure to exclude malignancy.