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Background and Objective: Colon surgery is one of the important operations in the abdominal area, but according to the type and conditions of surgery and clinical conditions, they can have different results and complications. The aim of this study is to determine the complications and related factors in patients who underwent colon anastomosis in emergency and elective surgery. Methods: In this cross-sectional study, 70 patients over 18 years of age and in need of colon anastomosis, who visited Kowsar Hospital in Sanandaj in 2017-2020, were examined in both emergency and elective groups. The patients were examined for complications such as bleeding, abscess, anastomotic leak, partial obstruction, fistula, and death, and the patients were followed up for six months, and if any of the complications occurred, the patient was hospitalized and examined further. Findings: The patients of the two groups did not have statistically significant differences in terms of demographic variables of age and gender, and surgery time. The highest frequency of the cause of surgery in the emergency group was volvulus in 10 cases (28.7%) and in the elective group was colon cancer in 26 cases (74.3%); in this regard, a statistically significant difference was observed between the two groups (p

Background and purpose: Colorectal resection is used for various diseases and leakage in an anastomosis is one of its complications. Some studies confirmed the predictive effects of C-reactive protein (CRP) and procalcitonin markers leakage in anastomosis. This study aimed to investigate the prognostic value of CRP and procalcitonin in predicting anastomotic leakage in elective colorectal surgery in Mazandaran province, Iran. Materials and methods: This longitudinal study was performed in patients (n=72) undergoing intestinal anastomosis in Sari Imam Khomeini Hospital, Oct 2016-March 2017. White blood cells (WBC), temperature (T), CRP, and procalcitonin levels were measured at days 3 and 5 after the surgery. Data were analyzed using SPSS V21. Results: Anastomotic leakage occurred in two patients (2.8%). Procalcitonin levels (P= 0.000), CRP levels at days 3 (P= 0.000) and 5 (P= 0.000), WBC at day 5 (P = 0.041), and body temperature at days 3 (P= 0.014) and 5 (P= 0.004) after the surgery were associated with the incidence of anastomotic leakage. Conclusion: Procalcitonin and CRP levels, WBC count, and body temperature were found to be correlated with anastomotic leakage, so they should be monitored at days 3 and 5 after the surgery to predict the incidence of complications.

Background: This study aims to evaluate the outcomes and late complications of open Roux-en-Y gastric bypass surgery in the treatment of morbid obesity. Methods: Over a 15 year-period between May 1997 and May 2012, we reviewed our experiments with 39 patients who underwent open gastric bypass for morbid obesity. The weight of the patient and surgical complications were recorded. Ideal weight, body mass index, weight loss and excess weight loss were calculated. Results: The follow up period ranged from 6 to 180 months with a mean of 100 months after operation. Average weight loss was 3.9 and 0.28 kg per month during the first and second years after operation weight loss was slower from the third year on-wards. Weight loss generally was stabilized between 12 and 18 months after operation. Only one patient (2.6%) had a weight loss failure criterion. Concomitant condition ex-isted in 14 patients (48.2%) of our series. These included hypertension in 3 cases (10.3%) that was resolved in 100%, diabetes mellitus in 4 (13.7%) that was resolved in 75%, cholelithiasis in 7 cases (24.1%) that was resolved by cholecystectomy during the operation. There was no early postoperative death. Early complications occurred in 2 patients (5.1%), including pulmonary embolism (2.6%) and gastrointestinal bleeding (2.6%). The late complications occurred in 7 patients (17.9%) involved 2 patients with anastomotic stricture at the gastrojejunostomy (5.1%), One patient with symptomatic cholelithiasis (2.6%), three patient with anemia (7.7%), and one patient had Wernicke ’s disease who died of this complication (2.6%). Conclusion: The results of the study showed that the open Roux-en-Y gastric bypass surgery is an effective procedure in the treatment of morbid obesity with minimal late complications.

Background: Tracheal anastomoses are common parts of upper respiratory airway surgeries. Anastomosis is currently performed using Vicryl sutures or staples. Due to the high prevalence of postoperative tracheal stenosis, efforts have been made to find alternative methods. This study compared the use of new fibrin glue in tracheal anastomosis with the classic method. Methods: Eight dogs of similar sex, weight, and race were included in this experimental trial. The surgery was performed in two different stages. In each stage, two rings of trachea were resected. In the first stage, anastomosis was performed with the new fibrin glue. In the second stage, the anastomosis was performed classically. After two weeks, the regions of anastomosis were resected for pathologic evaluations. Findings: There was a statistically significant difference in the mean duration of operation between the two methods (5.94 minutes using the fibrin glue method and 9.75 minutes using the classic method) and the mean tracheal diameter after anastomosis (25.59 mm and using the fibrin glue method and 24.14 mm using the classic method). In gross evaluation, there was not a significant difference between two different types of anastomosis. According to microscopic study, attachment was performed completely in all cases. Conclusion: Anastomosis with new fibrin glue was faster and with less postoperative stenosis and fewer complications compared to the classic method. Therefore, we claim this method as a suitable substitute for the classic method of tracheal anastomosis.

Introduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14%) of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5%) who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations.

Background: In many surgical procedures in pelvic and abdomen, gastrointestinal anastomosis has a main role.These days, bowel anastomosis is done with some techniques like handsewn and stapler anastomosis. In some research, the use of fibrin glue in abdomen is convenient, operation time is reduced, and intra abdominal adhesion is lower than standard manner. In this research we evaluated new fibrin glue for small bowel anastomosis in animal model. Methods: In this experimental study, we operated 5 dogs in same race, age and gender. After laparatomy under general anesthesia 5 cm of small intestine resected, then anastomos with new fibrin glue was done. After 15 days, the dogs were reoperated and surgical site was evaluated and then anastomosis was done by handsewn method. PASW version 18 was used for data analysis. Finding: Mean time for anastomosis with fibrin glue was 6:47 and 11:11 for handsewn. Mortality and peritonitis didn’t occur. After second operation there was no any sign of leakage, intraperitoneal inflammation and abscess. In microscopic only one case attachment wasn’t seen in mucosa and submucosal layers but it was occurred in muscular and serosal layers. Conclusion: The mean time of FG anastomosis was shorter than handsewn and the patency of surgical site was favorable beause there was no significant different between diameters of proximal and distal lumens compare whit normal bowel diameter. Our data reveals that we can use FG (that reinforced by nano particles) for reinforcement of GI anastomosis with high safety level, especially in high risk situation.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Polyethylene glycol (PEG) solution can induce complications when used as preoperative bowel preparation. The aim of this study was to compare two methods for mechanical bowel preparation in elective operations of colon."n"n Methods: In a randomized clinical trial, 129 patients elected for anastomosis of colon and referred to the surgical clinic of Imam Khomeini Hospital of Tehran between March 2008 and March 2009 were included. They were randomly allocated into two groups of PEG1 (1liter of PEG or 70gr plus 15 mg bizacodil, n=63) and PEG4 (4 liter of PEG), according to the way of bowel preparation; and on the day before surgery, they received oral and IV prophylactic antibiotics and cleared solutions. In the morning of the surgery, they received their medication during 240 minutes. Then, they underwent anastomosic surgery of colon. The principle variables recorded were nausea, vomiting, flatulence, Na and K in the night before surgery, patients' and surgeons' satisfaction from bowel preparation and postoperative infection and leakage. "n"nResults: The majority of the patients were male (62%). Nausea (28.57% vs. 98.48%, p=0.001), flatulence (36.51% vs. 95.45%, p=0.001), and vomiting (4.76% vs. 75.76%, p=0.001) were significantly lower in PEG1 and the patients' satisfaction were significantly higher (59.02% vs. 1.52%, p=0.001) Peroperative Na was significantly higher in PEG4 group (141.21±3.63 vs. 139.94±2.97mg/l, p=0.001) and serum K was significantly lower (3.55±0.25 vs. 3.76±0.21, p=0.001). Surgeons' satisfaction were significantly higher in PEG4 group (good to very good 72.73% vs. 43.54%, p=0.001). Postoperative infection of surgical site, anastomosis leakage and ICU admission were comparable between study groups. "n"nConclusions: Bowel preparation with 1 liter of PEG plus 3 bizacodile pills instead of 1 liter of PEG in patients undergoing elective anastomosis of colon is not only associated with lesser nausea, vomiting, flatulence, but also increases the patients' satisfaction and tolerance, lessens electrolyte disturbances and do not influence postoperative infection of surgical site and anastomosis leakage.

Aims: Gastric cancer is the most common cancer in men and the third most common cancer in women after breast cancer and colon. This study aimed to compare the complications and survival of two manual and suturing and suturing with stapler in esophagojejunostomy suturing followed by total gastrectomy. Materials & Methods: In this historical cohort study, 116 patients requiring total Gastrectomy were studied with proximal Gastric and Cardia cancer referred to a hospital with census method. Patients were studied by age, gender, type of surgery, leakage and other complications and one-year survival rates during hospitalization and at least 12 months after surgery. Data analyzed by SPSS 20 software and Chi-square, Independent-T tests, Kaplan-Meier and Cox regression. Findings: Suturing in 40 patients (34.5%) was manually and in 76 patients (65.5%) was with stapler. In manual suturing, 6 (15%) and in stapler suturing 2 (2.6%) leakage happened, which was statistically different (p=0.18). Mean operation time was 273.9±50.7min in manual suturing and was 252.3±65.8 in stapler suturing which was statistically different (p=0.25). In manual suturing 8 (20%) and in stapler suturing 4 (5.3%) deaths occurred which was statistically different (p=0.009). One-year survival rate was 31% and median survival rate was 15 months. Age and stage of disease had the highest correlation with survival rate. Conclusion: Due to the lower leakage rate and mortality after surgery, manual suturing is more effective than suturing with stapler. [ABSTRACT FROM AUTHOR]

Background: Tracheal anastomoses are common parts of upper respiratory airway surgeries. Anastomosis is currently performed using Vicryl sutures or staples. Due to the high prevalence of postoperative tracheal stenosis, efforts have been made to find alternative methods. This study compared the use of new fibrin glue in tracheal anastomosis with the classic method. Methods: Eight dogs of similar sex, weight, and race were included in this experimental trial. The surgery was performed in two different stages. In each stage, two rings of trachea were resected. In the first stage, anastomosis was performed with the new fibrin glue. In the second stage, the anastomosis was performed classically. After two weeks, the regions of anastomosis were resected for pathologic evaluations. Findings: There was a statistically significant difference in the mean duration of operation between the two methods (5.94 minutes using the fibrin glue method and 9.75 minutes using the classic method) and the mean tracheal diameter after anastomosis (25.59 mm and using the fibrin glue method and 24.14 mm using the classic method). In gross evaluation, there was not a significant difference between two different types of anastomosis. According to microscopic study, attachment was performed completely in all cases. Conclusion: Anastomosis with new fibrin glue was faster and with less postoperative stenosis and fewer complications compared to the classic method. Therefore, we claim this method as a suitable substitute for the classic method of tracheal anastomosis. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to evaluate the results and complications of tracheal stenosis and tracheal reconstructive surgeries. Methods: This descriptive study was conducted on patients whose tracheal stenosis was repaired by surgery in the Thorax Center of Alzahra Hospital (Isfahan, Iran) during 1998-2008. Data of patients including age, sex, etiology of stenosis, signs and symptoms onset after intubation, length of resected sections, postoperative complications, and patient's attitude toward recovery was collected and analyzed by descriptive statistics. Findings: A total number of 52 patients with the mean age of 39.15 ± 2.67 years were included and studied. Males constituted 75% of the population. The most common sign was dyspnea (75%). Postoperative complications included wound infection (7.7%), recurrent stenosis (21.2%), and disruption (1.9%). Mortality and success rates were 5.8% and 73%, respectively. In the follow up, hoarseness, mild dyspnea without significant function drop, and tracheostomy were observed in 5.8%, 3.8%, and 3.8% of the patients, respectively. In addition, in 7 patients, bronchoscopic dilation was performed after disease recurrence. Treatment was successful in 86.5% of the cases. Patients' attitude significantly improved in 50% of the patients and fairly improved in 34.6% of the subjects. However, 11.5% showed no improvement in the attitude and 3.8% admitted that their condition was worse. Conclusion: The intubation period was 21 days that is long. Therefore, more planning needs to be performed to reduce this time. Ultimate success rate was close to similar studies. [ABSTRACT FROM AUTHOR]

Background: In many surgical procedures in pelvic and abdomen, gastrointestinal anastomosis has a main role. These days, bowel anastomosis is done with some techniques like handsewn and stapler anastomosis. In some research, the use of fibrin glue in abdomen is convenient, operation time is reduced, and intra abdominal adhesion is lower than standard manner. In this research we evaluated new fibrin glue for small bowel anastomosis in animal model. Methods: In this experimental study, we operated 5 dogs in same race, age and gender. After laparatomy under general anesthesia 5 cm of small intestine resected, then anastomos with new fibrin glue was done. After 15 days, the dogs were reoperated and surgical site was evaluated and then anastomosis was done by handsewn method. PASW version 18 was used for data analysis. Findings: Mean time for anastomosis with fibrin glue was 6:47 and 11:11 for handsewn. Mortality and peritonitis didn't occur. After second operation there was no any sign of leakage, intraperitoneal inflammation and abscess. In microscopic only one case attachment wasn't seen in mucosa and submucosal layers but it was occurred in muscular and serosal layers. Conclusion: The mean time of FG anastomosis was shorter than handsewn and the patency of surgical site was favorable beause there was no significant different between diameters of proximal and distal lumens compare whit normal bowel diameter. Our data reveals that we can use FG (that reinforced by nano particles) for reinforcement of GI anastomosis with high safety level, especially in high risk situation. [ABSTRACT FROM AUTHOR]