Emmanuel M.D S. B. Ruiz, Edgar, Alexis F. Garcia, Axell , Daniel L. Rodriguez, Yessenia, Escobedo Fernandez, Juan, Francisco M. Muñoz, Gerardo, Alberto M. Solis, Francisco, Javier R. Vazquez, Jorge , Alberto V. Tovar
SAR J Sur | Pages : 90-94
DOI : https://doi.org/10.36346/sarjs.2025.v06i04.005
One of the most challenging tasks to accomplish in reconstructive plastic surgery is reconstructing the eyelids. Following eyelid surgery, function and appeal must be restored. The surgical reconstructive plan depends on the severity of the defect is and the degree to which there is tissue around the eye. Eyesight and quality of life may be considerably compromised by periocular cancers. The lower lid (48%) and the medial canthus (27%) exhibit more periocular malignancies than the upper lid (25%), which is protected from UV rays by the eyebrow. Basal cell carcinoma (BCC) is responsible for 80–92.2% of periorbital cancers. Surgery is suggested for periocular, periorbital, and eyelid BCC. There are several different types of surgery that may be used to fix eyelids. Mustard cheek flaps are a great way to fix problems with the lower and outer eyelids.
SAR J Sur | Pages : 85-89
DOI : https://doi.org/10.36346/sarjs.2025.v06i04.004
Right-sided colonic diverticulitis is commonly seen in younger and predominantly Asian patients, and it presents with pain over the right lower abdomen. The diagnosis is usually confirmed by imaging modalities like computerized tomography. It is divided into complicated or uncomplicated diverticulitis, with uncomplicated diverticulitis being managed with non-operative treatment. Complicated diverticulitis is managed with surgical resection, with either a right hemicolectomy or an ileocecal resection being performed. In this article, we will look at the management of right-sided colonic diverticulitis, especially the role of non-operative management and surgical resection.
S. Charboub, H. El Kamch, H. Laabarta, J. Hafidi, N. Gharib, A. Abbassi, S. El Mazouz
SAR J Sur | Pages : 76-84
DOI : https://doi.org/10.36346/sarjs.2025.v06i04.003
Perforator flaps have revolutionized reconstructive surgery by enabling reliable tissue coverage while significantly reducing donor site morbidity. Based on the use of small-caliber perforating vessels, these flaps allow the transfer of cutaneous and subcutaneous tissues without sacrificing muscle. Advances in the understanding of vascular anatomy and the use of preoperative imaging—particularly Doppler ultrasound and CT angiography—have enabled precise planning and safe dissection. Numerous variants have been developed, including deep inferior epigastric perforator (DIEP) flaps, anterolateral thigh (ALT) flaps, gluteal perforator flaps, and freestyle flaps, each with specific indications and advantages. The emergence of supermicrosurgical techniques, particularly perforator-to-perforator anastomoses, has expanded reconstructive options, especially for distal or complex tissue defects. This article provides a review of the principles, technical aspects, and clinical applications of perforator flaps, highlighting their central role in modern reconstructive surgery.
H. Sqalli Houssaini, D. Kartite, N.Y. Fall, A. Khales, A. Achbouk, K. Ababou
SAR J Sur | Pages : 72-75
DOI : https://doi.org/10.36346/sarjs.2025.v06i04.002
Eccrine porcarcinoma is an extremely rare malignancy of the skin with few well documented cases reported in literature. It is a malignant cutaneous adnexal neoplasm originating from the intraepidermal ductal portion of eccrine sweat glands. This tumor predominantly affects elderly patients, with a high potential for locoregional metastasis, significant morbidity, and mortality. We present a rare case of porocarcinoma affecting a 22-year-old patient on the lower limb, without extension. The initial tumor was biopsied, excised and diagnosed as an eccrine porocarcinoma. Reconstruction of the heel was achieved with a medial plantar flap.
Dr. D. Jaadi, Dr. G. Bennouna, Dr. A. Slaoui, Dr. H. El Kamch, Dr. C. Hmidi, Dr. H. Sqalli Houssaini, Pr. J. Hafidi, Pr. N. Gharib, Pr. A. Abbassi, Pr. S. El Mazouz
SAR J Sur | Pages : 66-71
DOI : https://doi.org/10.36346/sarjs.2025.v06i04.001
Acral melanoma is a rare but aggressive form of skin cancer, typically located on the palms, soles, or periungual regions. It carries a poor prognosis, particularly in North Africa, where diagnosis is often delayed. Sentinel lymph node biopsy (SLNB) is currently recommended for staging high-risk or thick melanomas, yet its specific role in managing acral melanoma remains underreported in Morocco. This retrospective descriptive study was conducted at CHU Avicenne between January 2020 and June 2024 and included five patients with histologically confirmed acral melanoma who underwent SLNB according to international guidelines. Clinical and histological parameters, sentinel lymph node status, and patient outcomes were analyzed. The average age was 61.2 years, with a mean diagnostic delay of 7.2 months. The sentinel lymph node was positive in 40% of cases, all involving thick and ulcerated tumors. In all positive cases, management was modified to include lymph node dissection and adjuvant immunotherapy. No deaths were observed during a median follow-up of 24 months. This case series highlights the frequent nodal involvement in acral melanoma in Morocco and emphasizes the value of SLNB in improving patient management and prognosis.
SAR J Sur | Pages : 62-65
DOI : https://doi.org/10.36346/sarjs.2025.v06i03.006
Malignant gastrocolic fistula is a rare and challenging clinical entity characterized by nonspecific symptoms, often leading to delayed diagnosis and management. Imaging modalities such as barium studies, contrast-enhanced CT scans, and upper gastrointestinal endoscopy are crucial for diagnosis. We report the case of a 44-year-old man who presented with anorexia, significant weight loss, and nausea. Upper Gl endoscopy and colonoscopy revealed a gastrocolic fistula secondary to invasive adenocarcinoma involving the stomach extending into splenic flexure as a fistula. The patient underwent a D2 gastrectomy with Roux-en-Y gastrojejunostomy and left radical hemicolectomy. Histopathology confirmed moderately differentiated adenocarcinoma with lymph node involvement. This case highlights the importance of timely diagnosis and aggressive surgical management in improving outcomes in such rare malignancies.
SAR J Sur | Pages : 57-61
DOI : https://doi.org/10.36346/sarjs.2025.v06i03.005
Meckel’s diverticulum is a congenital gastrointestinal anomaly commonly seen in the pediatric age group. It can be divided into symptomatic and asymptomatic presentations, with the most common clinical presentation being gastrointestinal bleeding, intestinal obstruction, and perforation. The diagnosis uses imaging modalities like ultrasound or computerized tomography, with the technetium 99 scan and angiography reserved for complicated presentations. Meckel’s diverticulum is treated by performing a diverticulectomy or resection, which can be performed as an open or laparoscopic procedure. The treatment of incidental Meckel’s diverticulum is an area of controversy due to the absence of any guidelines on management.
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