جستجوی مقالات مرتبط با کلیدواژه "عوارض جراحی" در نشریات گروه "پزشکی"

Diabetes is a significant risk factor for postoperative complications and mortality. However, there are different opinions about the relationship between the increase in glycosylated hemoglobin (HbA1c) level and the incidence of surgical complications.

In this retrospective study, 189 diabetic patients referred to Sabalan Hospital in Ardabil who were admitted for surgery were examined in 2021. The data related to demographic information, HbA1c test, postoperative complications, and the outcome of patients’ hospitalization were extracted from the records and entered into the researcher-made checklist. Patients were divided into two groups of uncontrolled diabetes with HbA1c of 7 and above and the controlled diabetes group with HbA1c below 7.

Out of 189 patients included in the study, 97 patients were in the uncontrolled diabetes group, and 92 patients were in the controlled diabetes group. The average age of diabetic patients in uncontrolled and controlled diabetes groups was 58.18±8.91 and 61.84±5.52, respectively. According to the results, surgical site infection and the need for re-surgery during hospitalization showed a significant relationship with an HbA1c level (p≤0.05). Other postoperative complications were not significantly different between the two groups.

It seems logical that elective surgeries should be postponed in HbA1c levels higher than 7% because the presence of high HbA1c levels indicates that the patient’s diabetes is not under control, and as a result, there is a higher probability of chronic complications of diabetes as well as a higher risk for post-operative complications.

Diabetes is a set of metabolic disorders that manifest with increased blood sugar. This is a large pandemic disease that has several hundred million sufferers and a similar number of people at risk, and some people also show a pathophysiology similar to diabetes during injury and severe stress. Diabetic patients require hospitalization and surgery more than other people, and the mutual effects of surgery and diabetes can affect the course of surgery or its complications. Knowing the effects of surgery on diabetes, diabetes and its drugs on surgery and how to manage blood sugar during surgery can be a basis for timely and correct decision making.

In recent years, laser-assisted surgery has become commonplace in dentistry, especially in soft tissue surgeries. The present study aimed to investigate the complications and patient satisfaction after removing exophytic lesions by laser surgery.

A total of 12 patients requiring removal of peripheral exophytic lesions such as reactive hyperplasia and mucosal surgery were examined to participate in the present study.

This surgical procedure had the maximum patient satisfaction (84%) and almost all patients (91.7%) had no postoperative pain. After three weeks, the wound site healed in all patients, although a case of mucosal recurrence was observed in this study.

Laser surgery is quite successful due to the absence of pain, maximum patient satisfaction, and wound healing in all patients which is consistent with the results of previous studies, although this method requires a more complete evaluation.

Abdominal aortic aneurysms (AAA) is a localized enlargement of infrarenal abdominal aorta. Endovascular aneurysm repair (EVAR) is a surgical method introduced for AAA repair. This study, for the first time in Iran, investigated the complications and mortality rate associated with EVAR. 

In this cross-sectional study, medical records were reviewed and all patients admitted to Sina Referral Hospital with infra renal abdominal aortic aneurysms who underwent elective EVAR between 2011 and 2019 (n=130) were studied.

There were 121 complete files, including those of 104 (85.9%) men and 17 (14.1%) women. The mean age of patients was 70.56±9.4. Renal complications were the most frequent systemic complication after elective EVAR (n=15, 12.6%). Cardiac complications (n=10, 8.4%), respiratoty complications (n=6, 5%), cerebral complications (n=3, 2.5%), and deep vein thrombosis (n=2, 1.7%) were also reported. There was no graft infection. More than half of the procedure-related complications occurred in 6 months of surgery (n= 29, 24%).

Endovascular repair of abdominal aortic aneurysm especially in patients with comorbidities has acceptable results in short term and long term surveillance.

Knee arthroplasty is one of the most successful orthopedic surgeries, and many studies have been done on Eproch and the timing of surgery, but few studies have been performed on the outcomes and complications of knee arthroplasty and its comparison 48 hours later. Therefore, we decided to conduct a study to determine the clinical outcomes and complications of two knee joint replacements and to compare them within 48 hours.

This study was a cohort study, the first group consisted of patients undergoing concurrent arthroplasty and the second group were patients undergoing 48 knee arthroplasty within 48 hours then postoperative complications, duration Time of hospitalization, clinical outcome two weeks after surgery, one month after surgery and three months after surgery were evaluated.

None of the criteria evaluated by lysholm questionnaire were significantly different in the studied patients. Postoperative complications were also evaluated in both case and control groups, with no significant difference in either group. (P> 0.05).

Overall, there was no significant difference in pain rate, knee function, and surgical complications during the study after both treatments.

With the introduction of the COVID 19 in China, major changes have taken place in patients management. General recommendations for minimum surgeries became widespread only in emergencies. Various centers reported bitter experiences of patient’s complications and changes in outcome. Among these, two groups of patients require surgery despite the risks of COVID 19, cancer patients and patients requiring emergency surgery. In this study, we report our experience of surgery in these two groups of patients who underwent surgery at the COVID 19 outbreak.

Due to the relatively high complications of hypospadias surgery,the aim of this study was to determine the incidence and risk factors for hypospadias surgery complications in children undergoing surgery at Aliasghar hospital in Tehran in 2017.

This descriptive-analytical study was performed on 90 children over six months who underwent surgical treatment of hypospadias. Information on risk factors was collected by a researcher-made questionnaire at the time of admission and at the time of discharge. Also, surgical complications were evaluated two weeks after surgery and up to one year after that and entered in a questionnaire. Findings were analyzed using t-test and chi-square test or Fisher Exact test.

The only surgical complication was urethrocutaneous fistula, which was seen in 18.9% of patients. Risk factors associated with complications of hypospadias surgery include low birth weight, preoperative testosterone injection, presence of penoscrotal or scrotal hypospadias, Ducket`s surgical technique and  Prolonged retention of the urinary catheter, but the age of the child at the time of surgery, gestational age, and family history of hypospadias  were not associated with surgical complications.

It is recommended to be more careful in terms of surgical technique, especially in children with low birth weight and penoscrotal or scrotal hypospadias, and if possible, avoid testosterone before surgery and Ducket`s technique for surgery.

Femoral neck fracture is associated with a high rate of side effects, especially in young people, who are usually affected by severe energy shocks. Results after injury depend on some factors, including displacement, fragility, bleeding rate, proper placement, and stable and strong fixation. The aim of this study was to compare dynamic hip screw (DHS) or multiple cannulated screws (MCS) in fractures of the femoral neck base.

In this cross-sectional study, 78 patients with femoral neck fracture were treated by internal fixation: MCS (n= 26) and DHS (n= 52) in Babol Shahid Beheshti Hospital, 2016-2018. Complications, including pain and lameness, infection, avascular necrosis (AVN), and nonunion were investigated in both groups. The visual analog scale (VAS) score and Harris Hip Score (HHS) were also compared between the two groups.

Mean ages of the patients in MCS group and DHS group were 54.19 ± 23.35 and 58.50 ± 21.06 years, respectively. In patients treated by MCS, infection, AVN, no welding, and pain and lameness were seen in 3, 2, 3, and 6 patients, respectively, while these complication were observed in 1, 1, 1, and 4 patients in the DHS group, respectively. The rate of complications were not found to be significantly different between the two group (P>0.05). The mean VAS score was significantly lower in the DHS group compared to that in the MCS group (P<0.05). The HHS scores were not significantly different between the two groups (P<0.05).

According to this study, MCS is more appropriate in the treatment of femoral neck fractures due to less bleeding and shorter operation time.

Pyoderma gangrenosum (PG) of the breast is a rare that present as a painful ulcer on the skin. It usually affects people in their 20s to 50s and occurs in both men and women. Typically, PG affects the legs in adults. In children, it may affect the legs, buttocks, head, and neck. Pyoderma gangrenosum is characterized by a papule, nodule, or pustule that progresses to an injured lesion with unknown boundaries. In this study, a case of Pyoderma gangrenosum is introduced after breast surgery.A 38-year-old woman with a 3 cm wound in the right breast area that has gradually grown has been examined for exudative bloody discharge for the past 2 weeks. Two weeks after breast surgery, a three-centimeter progressive wound has formed on the surface of the breast, which gradually grew larger. During treatment, several oral and injectable antibiotics were prescribed that have not been effective in healing the wound. A biopsy lesion was reported in which a non-specific skin lesion with hyperplasia and vesicle formation without malignancy was reported. The patient had no gastrointestinal symptoms. Infliximab was started and continued for the patient.

In the differential diagnosis of resistant skin wounds, especially in the leg area, and in this case in the breast the diagnosis of pyoderma gangrenosome should always be considered.
Even if the patient has no history of inflammatory bowel disease, pyoderma gangrenosum may occur before intestinal manifestations.

Brain tumors are rare and yet a significant cause of mortality and morbidity in adults. Surgical resection has been treatment of choice for brain tumors. Despite its effectiveness, surgical resection may cause various post-operatives complications such as infections, neurological deficits, and vascular damages that can lead to decrease in quality of life and survival rate and can impose great medical expenses. This study was aimed to assess related factors of medical and surgical complications after surgical brain tumors resection.

This was a descriptive and retrospective study performed on patients that underwent brain surgical tumor resection at Rasoul Akram Hospital of Iran University of medical science in Tehran, 2016. Age, sex, extent of resection, pathology of tumor, post-operative symptoms and complications, duration of surgery, blood loss volume during surgery, and duration of admission were collected, and analyzed with SPSS.

Of 179 patients, 47.5% (85) were male, and 52.5% (94) were female. Mean patient age was 45.8 years old, and mean admission duration was 4.6 day before and 9.7 day after surgery. The most common surgical complications were hydrocephalus (13.4%) and ICH (9.5%). The most common medical complication was electrolyte disorder (13.4%). Mean surgery duration was 1 hour 40 min and mean blood loss during surgery was 542 ml.

Based on our study, extent of brain resection was correlated with surgical and medical complications. Older age, longer duration of admission, and longer duration of surgery were correlated with medical complications, but it was not correlated with surgical complications. Older age was correlated with higher mortality rate. Blood loss volume during surgery had no correlation with surgical or medical complications.

The use of supplements such as L-carnitine, optimum nutritional support and early feeding after surgery in cancer patients can be important in the prevention of cancer complications. The aim of this study was to determine the effects of early L-carnitine-rich feeding on complications of esophageal cancer surgery and duration of hospitalization.
In a clinical trial, 50 patients with esophageal cancer under surgery in two equal groups were randomly selected. Nutritional information was obtained using food record questionnaire. Basic blood samples and 24-hour urine samples were taken in order to measure the hematological parameters (like blood cell count, hemoglobin, hematocrit and blood urea) and nitrogen balance, respectively from two groups at the beginning and end of the study. Then, the intervention group received 3 g L-carnitine daily in 3 doses on the first day after the complementary operation, with a routine hospital diet at each meal, and the control group received a routine hospital diet for ten days. Data were analyzed using independent t-test, paired t-test and chi-square test.
The results showed that changes in the mean BUN and nitrogen balance were significantly different after intervention between the study groups (p The results of this study showed that early L-carnitine-rich feeding after surgery has probably a positive effect on the duration of hospital stay in patients with esophageal cancer.

The cancer of the pancreatic head and Ampulla of Vater is a malignant disease usually seen in advanced stages with symptoms caused by stomach and biliary obstruction. Curative treatment is possible in the early stage. Unfortunately, most symptomatic patients are in the advanced stage and have an unrespectable tumor; therefore, they should undergo palliative surgery. This study was performed to determine the complications and survival rate of patients who underwent palliative surgery for advanced stages of cancer in the Ampulla Vater and pancreatic head.
In this study, 49 patients with advanced stages of cancer in the Ampulla of Vater and pancreatic head who had undergone palliative surgery from 2003 to 2014 at Baqiyatallah Hospital were studied and the complications and survival rate were determined.
Eleven patients (22.44%) underwent biliary bypass, 6 (12.24%) underwent gastric bypass, and 32 (65.32) underwent both procedures. Twelve (24.49%) patients developed complications. Anastomotic leak and peritonitis were the most common complications seen in 6 (12.2%). Seven patients (14.28%) died in the hospital. The mean survival was 5.47 ± 8.38 months. Upon follow up, survival was significantly longer in older patients (P=0.01).
In one-fourth of the patients with advanced stages of cancer, palliative surgery of the pancreatic head and Ampulla of Vater caused complications, and the mean survival rate was less than six months. The results of this study recommend the use of less invasive procedures such as biliary stenting in the advanced stages of the disease.

Background and Sternal Wound Infection (SWI) is a serious complication of median sternotomy that increases the rate of mortality. We report our experience of managing SWI in a regional cardiothoracic unit in Mazandaran province, Iran.
We prospectively studied 4725 patients who underwent isolated coronary artery bypass grafting between March 2012 and March 2015. Information about age, sex, morbidities, surgical factors and nature of sternal wound infection were recorded. Treatment options were stratified by nature of infection, and timing and nature of management. Data analysis was done using Med calc soft ware and p-values less than 0.5 were considered significant.
Sternal wound infection occurred in 49 (1%) patients. There were 26 (0.55%) superficial and 23 (0.48%) deep SWIs. SWI patients were found to be mainly females, with diabetes or hypertension, high body mass indices and longer aortic cross-clamp time. All patients with superficial SWI were managed by skin debridement and closure. Patients with deep SWI who had surgery within 48 hours of diagnosis were managed using skin and bone debridement and sternal rewiring following mediastinal drain. The mortality rate was found to be high in patients with SWI (12.2%).
Low sternal wound infection can be achieved with an ongoing focus on appropriate infection control. SWI significantly increases the risk of mortality which could be reduced through early intervention.

Neoplasms of the parotid glands are rare and constitute 3-4% of all head and neck tumors. The aim of this study was to determine the epidemiology of parotid surgeries at the ear, nose, and throat (ENT) department of Shafa Hospital, Kerman, Iran. In a cross-sectional study from March 2006 until March 2011, all patients who had had parotidectomy at Shafa Hospital (n = 47) were included. Their tumor type, pathology, age, gender, type of surgery, and early surgery complications were evaluated. The mean age of the patients was 40.1 years and 20 of them (42.6%) were male. Seven cases (14.9%) had malignant tumors and 37 (78.7%) had benign tumors. Total and subtotal parotidectomy were performed for 21.3% and 78.7% of the patients, respectively. Early complications of surgery were detected in eight cases (17.0%), i.e. four cases (8.5%) had facial paralysis, three patients (6.4%) had hematoma, and one individual (2.1%) had an infection. Malignancy was not significantly related with either age or gender. The prevalence of benign and malignant tumors and complications of surgery in this center was similar to other national and international studies. Systematic data collection and appropriate databases should be established to increase accuracy and reduce errors in similar research.

There are different surgical procedures for circumcision. Although the classic method is the most common one, it takes more time and causes more pain and complications compared to other methods. The purpose of this study was to compare the complications and the time taken for performing the surgery for Gomco and classic methods of circumcision.

This case-control study was performed on 80 neonates referred to the outpatient operating room in Shahid Beheshti hospital for circumcision in 2011 and were divided into two equal groups: one group underwent the classic method and another, the Gomco method. The complications were assessed in two phases: during the surgery by counting bloody gauze pads and one week thereafter using the objective methods, then they were analyzed statistically.

The mean age of neonates was 24.8±12.37 days and no significant difference was seen between two groups. The mean operation duration in the classic method (24.3±2.5 min) was approximately two times greater than that of the Gomco method (13.3±2.3 min). Moreover, the amount of bleeding in the classic method (4.1±0.6 cc) was over three times greater than that of the Gomco one (1.3±0.7 cc). No cases of infection were seen in both groups.

Results show that the Gomco method takes less time and causes less pain and fewer complications compared to the classic method and may also be a suitable alternative to the classic method.

Many patients with inguinal hernia are operated and hemovac is used to drain extra fluids from the surgery site. In this study, we compared the results of surgery in patients operated with hemovac vs. who had not hemovac. In a randomized clinical trial, 86 patients with inguinal hernia were assigned into two groups. Patients were operated by Lichtenstein method and hemovac was used in one group. The short- term outcome was compared between two groups. Severity of pain in hemovac group was mild in 0 cases, moderate in 6 and severe in, and in non hemovac group was mild in 9 cases, moderate in 0 and severe in. Severity of scar in hemovac group was mild in cases, moderate in 0 and severe in, and in non hemovac group was mild in cases, moderate in 6 and severe in. Inflammation in hemovac group was mild in, moderate in 0 and nobody had severe inflammation, while in non hemovac group was mild in cases, moderate in and severe in. There were no significant differences in pain, scar and inflammation among groups with and without hemovac. Using hemovac in inguinal hernia repair does not have effect on the healing of surgery site

Parotid surgery accompany with complications including facial nerve paresis, cosmetic deformities, gustatory sweating syndrome, salivary fistula, wound hematoma and infection. The aim of this study was to review an individual surgeon’s experience of parotidectomy and to evaluate its complications.

In a retrospective and descriptive analytical study, fifty patients with parotid tumor over six year (2000-2006) period were operated and evaluated considering early and late complications.

Fifty patients were recruited in this study; 24 (48%) males and 26 (52%) females. Thirteen patients underwent total parotidectomy (7 patients with benign tumor and 6 patients with malignant tumor). The remaining was under superficial parotidectomy. Post-operative complications included transient facial paresis (8%), gustatory sweating syndrome (12%), salivary fistulae and sialoceles (4%), hematoma (2%) and flap necrosis (2%). Wound infection and permanent facial nerve weakness were not observed in the present study. All the cases of gustatory sweating syndrome (Frey’s syndrome) were in benign disease group.

Despite lack of nerve stimulator during the surgery, the frequency of facial nerve weakness was low, compared to the previous studies. Therefore surgical technique plays major role in controlling the parotidectomy complications including facial nerve paresis.