فهرست مطالب

نشریه جراحی ایران
سال بیست و نهم شماره 1 (بهار 1400)

تاریخ انتشار: 1400/03/26
تعداد عناوین: 10

فارسی
English

انتخاب همه

A Narrative Review of Intestinal Failure, Parenteral Nutrition, Rehabilitation and Transplantation of the Intestine in Iran

S.Nikeghbalian, P.Arasteh, H. Nikoupour, Mojtaba Shafikhani, V. Zangouri, H.Nikoupour, S. AMalekhosseini Pages 1-10

In this narrative review we aimed to evaluate the status of intestinal failure, parenteral nutrition, intestinal rehabilitation and transplantation in Iran.All published articles related to intestinal failure, home and hospital-based parenteral nutrition, reconstructive surgery of the gastrointestinal system and intestinal transplantation in Iran were reviewed. We reported on the epidemiology and pathophysiology of intestinal failure, the importance of home parenteral nutrition, management of home parenteral nutrition for patients with intestinal failure, appropriate treatment steps regarding intestinal rehabilitation for short bowel syndrome and radiation enteritis and finally we reported on the condition of intestinal transplantation in Iran.Considering that in Iran we have not yet established home parenteral nutrition services, patients require long hospitalizations to receive parenteral nutrition which is associated with high costs for the health care system, decreases in quality of life of patients, and more importantly exposes patients to hospital related infections and as a result many of these patients die after acquiring infections despite receiving high dose antibiotics. Considering the lack of home parenteral nutrition in our country as the first treatment line, by establishing intestinal rehabilitation units in large hospitals and by providing services including parenteral nutrition, intestinal reconstruction and transplantation we will be able to prevent many deaths due to intestinal failure and decrease the need for intestinal transplantations.

Keywords: Intestinal Failure, Transplantation, Parenteral Nutrition, Home Parenteral Nutrition

Abstract View Paper Review Article Original: Persian
Comparison of the Outcome of Repeat Surgery versus Medical Treatment with Somatostatin Analogue in Persistent and Recurrent Cases of Acromegaly Referred to Pituitary Clinic of Sina Hospital between 2013 and 2018

S.Dalfardi *, Peimaneh Heydarian, K.Karimi Yarandi, M. Shirani, A. Amirjamshidi Pages 11-21

Introduction & Objective

A lot of data exists in the literature about de novo acromegaly and the results of treatment with somatostatin analogue (SSA) and primary surgery. However, in recurrent and persistent acromegaly researches are sparse. The main subject of current study is evaluation of surgery and treatment with SSA in recurrent and persistent acromegalic patients.

Materials & Methods

In this historical cohort study, the target patients were the ones referred to pituitary clinic of Sina Hospital between 2013 and 2018. Two methods of repeat surgery (as preferred option) and medical treatment with SSA were advised to patients and the treatment was finally chosen according to the patient’s will. Visual field, pituitary MRI, basal GH, IGF1, OGTT were assessed in months 3, 6 and 12 of follow-up. Finally, the rate of favorable outcome (OGTT < 1 ng/ml, without any new visual field deficit and tumor regrowth) and remission (normal GH and normal IGF1) were separately assessed.

Results

Of 14 patients collected in surgical group (6 microadenomas and 8 macroadenomas) remission was achieved in 57% (8 cases) and favorable outcome was found in 64% (9 patients). In 16 patients of medical group remission was achieved in 62% (10 cases), while favorable outcome was seen in 25% (4 patients).

Conclusions

It seems that in pure monohormonal non-metastatic recurrent acromegaly with a resectable and accessible mass in imaging the preferred approach can be surgery. In high risk patients and in cases who prefer medical therapy or cases with unresectable mass medical treatment with SSA can be advised.

Keywords: Acromegaly, Somatostatin Analogue, Repeat surgery, Adenoma, Pituitary

Abstract View Paper Research/Original Article Original: Persian
Evaluating the Sensitivity and Specificity of CT Scan Images in the Screening of Trauma Patients with COVID-19

H.bdolrahimzadeh Fard *, H. R. Abbassi, S.Sefidbakht, P.Iranpour, A.Taheri Akerdi, A. Niakan, L. Shayan, S. Zare, Sh.Paydar Pages 22-33

Introduction & Objective

The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients.

Materials & Methods

This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT-scans were evaluated in a blinded manner and main CT scan features were described and classified into four groups according to North American Society of Radiology recommendation. Subsequently, the first two North American Society of Radiology categories with the highest probability of COVID pneumonia (i.e. typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID pneumonia into “negative CT scan group”.

Results

Chest CT scan had a sensitivity (68%), specificity (56%), positive predictive value (34.8%), negative predictive value (83.7%), and accuracy (59.3%) in detecting COVID-19 among trauma patients. Also, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals a sensitivity of 100% and a specificity of 66.7% and a negative predictive value of 100% was obtained.

Conclusions

Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 in comparison to non-traumatic people.

Keywords: COVID-19, Computed Tomography, Radiology, Trauma

Abstract View Paper Research/Original Article Original: Persian
Frequency of the Complications after Total Gastrectomy in Gastric Cancer in the Shahid Beheshti and Ayatollah Rohani Hospitals Babol in the Year 2002-2015

Sh.Ghajar *, A. Noorbaran, S. Khafri, Y. Asghari, S. Kamali Ahangar, K.Nikbakhsh, N. Nikbakhsh Pages 34-46

Introduction & Objective

Gasrtic cancer is the second lethal cancer in the world. Surgery is the definite treatment for gastric cancer. Standard surgery is Radical Subtotal Gastrectomy and there is no need to total gastrectomy because of high mortality and morbidity rate. Therefore the aim of this study was assessment of frequency of complications after total gastrectomy in gastric cancer.

Materials & Methods

In this study we evaluated complications of total gastrectomy in 100 patients with gastric cancer. Inclusion criterias was consent of patients and diagnosis of gastric cancer with endoscopy and take stomach biopsy and who undergone total gastrectomy: Frequency of the complications after total gastrectomy, demographic and pathologic data included in check list. Data were analyzed by SPSS software version 16 by logistic regression and chi-square tests.

Results

100 patients were entered in our study. Mean age of them was 67.77 years old. There were 72 male and 33 female patients that 50% (50 patients) experienced complications of total gastrectomy, that male to female ratio was 42 to 8. 20% of them were less than 60 year old and 80% of them were more than 60 year old. The most complication was Bile reflux (22%), Laparotomy side bleeding (13%), Wound infectin (8%), fistule, Leakage of anastomosis, severe reflux esophagitis, stricture of anastomosis were 4% separately. Obstruction of the anastomosis was 1% and the other complications were 27%.

Conclusions

Frequency of the complications after total gastrectomy was 50% and male was the risk factor of total gastrectomy complications (P = 0.007).

Keywords: Total Gastrectomy Complication, Gastric Cancer, Fistule, Leakage of Anastomosis

Abstract View Paper Research/Original Article Original: Persian
Frequency of Anus-Associated Abnormalities in Children Referred to Taleghani Educational and Medical Center in Gorgan during the Years 2008-2018

H B.Taneh *, A. A.Aghainejad, N. Abedian, Sh. Rahimian, S.Nourani Kolteh Pages 47-56

Introduction & Objective

Anorectal abnormalities are one of the most common congenital structural abnormalities in pediatric surgery with one in 4.000 to 5.000 live births. The cause is not fully understood, but environmental and genetic factors may be involved. The most common accompanying abnormalities are genital, spinal, and cardiovascular abnormalities. Recognizing the abnormalities associated with this problem and their timely diagnosis and treatment will help these people to suffer less from the complications caused by these abnormalities. The aim of this study was to investigate the frequency of anus-associated abnormalities in children referred to Taleghani Hospital in Gorgan during the years 2008-2018.

Materials & Methods

This retrospective descriptive study was performed on 203 infants and children with closed anus referred to Taleghani Educational and Medical Center in Gorgan in 2008-2018. To collect data after obtaining permission, patients' files were accessed. The required data were collected through the patient's clinical file, which included clinical examinations and diagnostic procedures, and additional information was collected through contact with parents and physicians. Data were analyzed and presented for SPSS software version 18 using descriptive statistics (mean, standard deviation, frequency and frequency percentage).

Results

From 203 infants and children with closed anus, 25.1% were under 28 days old and 74.9% were over 28 days old. The mean age of patients in this study was 1.91 ± 1.85 years, most of whom were male. Also in the study of ethnicity that was done, the most ethnicity was to Persia and the lowest was Baluch ethnicity. 15.3% of children had no abnormalities, while 84.7% had at least one abnormality with closed anus. 5 cases of the most common anomalies with this defect in the subjects included ASD (26.6%), PDA (21.7%), recto-urethral fissure (21.2%), patent foramen ovale (15.3%), and recto-vaginal fissures (14.8%) were seen in patients. As the results showed, congenital heart anomalies were the most commo and then Gastrointestinal and genital fissures have since been reported.

Conclusions

The results of this study showed the high prevalence of concomitant anomalies in infants and closed anal children in Gorgan region that congenital heart anomalies are the most common anomalies with closed anus. Therefore, this result shows the importance of timely examinations and paraclinical procedures at birth.

Keywords: Accompanying Anomalies, Anus Closed, Children

Abstract View Paper Research/Original Article Original: Persian
Fabrication and Characterization of Bilayer Wound Dressing Polyurethane- Gelatin/ Polycaprolactone for Usage in Tissue Engineering

A. Hedayatnazari *, M. Movahedi, M. Naseri Pages 57-68

Introduction & Objective

Infection is one of the main causes of delayed wound healing. In addition to infection, in some chronic wounds, such as diabetic wounds, the wound heals slowly due to reduced angiogenesis. For this purpose, a two-layer dressing consisting of gelatin / polycaprolactone nanofibers and polyurethane film can be a suitable solution to accelerate wound healing.

Materials & Methods

In order to make double-layer polyurethane - gelatin / polycaprolactone nanofiber dressing. Solution of Polyurethane (12%W/v) in tetrahydrofuran / dimethyl formamide is first placed on a magnetic stirrer. After the formation of a uniform solution, the solution is formed on Teflon molds in order to prepare a film by solvent casting. The polycaprolactone / gelatin polymer solution is then prepared at ambient temperature at a concentration of 10% by weight, and finally the fibers are spun randomly onto the fabricated polyurethane film.

Results

The morphology of the bilayer dressing was examined by scanning electron microscopy. Tests such as water absorption, mechanical properties (fracture strain and tensile strength), contact angle and cytotoxicity were performed. The contact angle test for polycaprolactone and polycaprolactone / gelatin nanofibers was measured at 114 and 44 degrees, respectively. Tensile strength for double-layer scaffolding was 4.46 MPa and fracture strain was reported at an average of 330%. Cytotoxicity test showed that the samples were not toxic. Fibroblast cells also showed good adhesion to the dressing.

Conclusions

The results of studies showed that double layer dressing can be a suitable solution for the treatment of diabetic infectious wounds also Skin Tissue Engineering.

Keywords: Polyurethane, Gelatin, Polycaprolactone, Skin Tissue Engineering

Abstract View Paper Research/Original Article Original: Persian
An intracystic Papillary Carcinoma of the breast in a 44 year-old Male

S. A.Jalali *, M.Shafii Pages 69-75

Intracystic papillary carcinoma of the breast is a rare form of breast carcinoma in female; yet it is very rare in male; those cases reported are very scarce and usually are in the elderly age group.Unusually our case is a 44-year-old male that felt a lump in his periareolar region, on his left breast, for two months before being seen in the clinic; he had an U.S. scan that showed a simple cyst without septation. The cyst was aspirated which revealed a clear yellow-green aspirate; and the cyst disappeared on palpation. The cyst recurred and the patient was scheduled for surgery; the cyst was removed completely with a safe margin of normal breast tissue.No evidence of neoplastic activity was detected in surrounding tissue. The pathology report was an intracystic papillary carcinoma of the breast (IPC), and was confirmed by IHC. The ER and PR were strongly positive and HER-2 negative. As IPC is very rare in men, as far as we know it has not been reported in Iran so far, and concerning the age of the patient only few cases has been repored in the world.

Keywords: IPC – Intracystic Papillary Carcinoma, Male-Breast Carcinoma, Breast Cyst

Abstract View Paper Case Report Original: Persian

علمی مصوب

نشریه جراحی ایران

Iranian Journal of Surgery

فصلنامه پزشکی

آخرین شماره | آرشیو

ISSN: 1735-4099

صاحب امتیاز:

جامعه جراحان ایران

مدیر مسئول:

دکتر ایرج فاضل

سردبیر:

دکتر مصطفی جابرانصاری

تلفن نشریه: ۰۲۱-۲۶۷۵۵۴۱۱

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فهرست مطالب

نشریه جراحی ایران سال بیست و نهم شماره 1 (بهار 1400)

نشریه جراحی ایران

Iranian Journal of Surgery

نشریه جراحی ایران
سال بیست و نهم شماره 1 (بهار 1400)