Cerebral palsy (CP) is a group of non-progressive neuromotor disorders resulting from early brain injury, and it is the most common cause of chronic physical disability in children [1]. The motor i...

Background Defunctioning stomas are standard in low anterior resection (LAR) posttotal neoadjuvant therapy (TNT) to mitigate anastomotic complications. While loop ileostomy is common, it poses significant metabolic risks. This study investigates whether loop colostomy may reduce renal and electrolyte complications, without compromising surgical or stoma reversal outcomes. Methods We retrospectively analyzed 97 patients with rectal cancer treated at King Hussein Cancer Center (January 2020 to November 2024) who underwent TNT followed by LAR with a defunctioning stoma (ileostomy, n = 57; colostomy, n = 40). Primary outcomes were acute kidney injury (AKI) and hyponatremia. Secondary outcomes included stoma-related and closure-related complications. Data were compared using chi-squared, Mann–Whitney U-test, and Kaplan–Meier analysis. Results Baseline characteristics were comparable, except for higher baseline creatinine in ileostomy patients (p = 0.002). Ileostomy was associated with more AKI (35.1% versus 2.5%, p < 0.001) and hyponatremia (57.8% versus 20.0%, p < 0.001) with greater stoma output (p < 0.001). Skin excoriation was more frequent with ileostomy (24.5% versus 5.0%, p = 0.011), while colostomy had higher stoma prolapse (22.5% versus 1.7%, p < 0.001). Other postoperative outcomes were similar. However, blood loss during stoma reversal was greater with ileostomy (p < 0.001). Kaplan–Meier analysis showed no difference in time to closure (median 84 versus 85 days, p = 0.491). In multivariate analysis, ileostomy remained associated with AKI and hyponatremia after adjustment for the included covariates. Conclusions Loop colostomy may represent an alternative to loop ileostomy after LAR following TNT, with fewer metabolic complications and comparable surgical outcomes, despite a higher prolapse risk.

Background/Objectives: Radiation therapy for left-sided breast cancer exposes the heart and lungs to incidental radiation, increasing long-term risk of cardiopulmonary morbidity. This study evaluated the dosimetric impact of DIBH compared with free breathing (FB) and explored patient- and treatment-related predictors of benefit. Methods: We retrospectively analyzed 90 patients with left-sided breast cancer or chest wall irradiation planned under both FB and DIBH. Dosimetric parameters included mean heart dose (MHD), mean lung dose (MLD), heart V5, and lung V20. Univariable analyses assessed associations between dose reductions (Δ%) and clinical factors (age, BMI, fractionation, boost, nodal fields, and smoking). Multivariable regression identified independent predictors. Results: DIBH significantly reduced mean doses to the heart (FB 4.25 ± 1.47 Gy vs. DIBH 2.64 ± 1.28 Gy; Δ −1.60 Gy, p < 0.001, and Cohen’s d = 2.46) and lung (FB 14.00 ± 3.45 Gy vs. DIBH 11.64 ± 3.32 Gy; Δ −2.36 Gy, p < 0.001, and Cohen’s d = 2.73). Similarly, heart V5 (median Δ −10.5%, p < 0.001) and lung V20 (median Δ −5.5%, p < 0.001) were significantly improved. Higher BMI was independently associated with smaller relative reductions in MHD (−1.4% per unit, p < 0.001) and MLD (−0.31% per unit, p = 0.019). Hypofractionation was linked to greater MHD and MLD reductions (+8.9%, p = 0.007), (3.7%, p = 0.035), respectively. Supraclavicular field irradiation increased lung exposure, while internal mammary chain fields elevated both lung and heart doses. Age showed no significant influence. Conclusions: DIBH provides robust and consistent reductions in cardiac and pulmonary radiation doses during left-sided breast irradiation. The degree of sparing is modulated by BMI, fractionation, and nodal field inclusion.