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Constructing successful anastomosis is an important concept in gastrointestinal tract surgeries, which can be affected by various factors such as preoperative bowel condition, intra- and postoperative complications, bleeding and the device characteristics. Suturing, stapling and compression anastomosis are different techniques. Despite the invention of compression anastomosis, which goes back almost two centuries, this method has not obtained the popularity of the suturing and stapling anastomosis and further studies are required. Designing methods and devices with no drawbacks might reduce the complications associated with anastomosis as the alternative to suturing and stapling anastomoses. Several materials can be used as reinforcement materials, which can improve the consequences of the stapled anastomosis. In addition to reinforcement materials, other forms of supports have been proposed, which might be capable of reducing the postoperative complications of anastomosis. In this study, we briefly review various types of anastomotic techniques and associated complications in different types of gastrointestinal surgeries. [ABSTRACT FROM AUTHOR]

Introduction: Intraoral synechia is a rare congenital condition, generally associated with other maxillofacial malformations. We present a neonate with congenital intraoral bilateral synechia without any other facial anomalies. Case Report: In this paper, we present a 19-day-old male neonate with congenital intraoral bilateral synechia without any other facial anomalies. We review the literature to discuss the surgical and anesthesia management of this rare congenital disease. Conclusion: The disease manifested with a wide spectrum of symptoms. Most cases need surgery and airway management. In patients with a low risk of bleeding or a compromised airway, it is possible to manage them with face mask-inhalation anesthesia and maintain spontaneous breathing. [ABSTRACT FROM AUTHOR]

Surgery has dramatically improved survival of infants with esophageal atresia. However, early and late complications of these surgeries affect the future life of this population. A probable step toward minimizing such complications is through modifying the technique of surgery. We evaluated two groups of esophageal atresia undergoing surgery with two different techniques including preservation and ligation of the Azygos vein and compared early complications, duration of surgery, and hospital and neonatal intensive care unit (NICU) stay between them. A total number of 24 patients with mean age of 24 to 48 h, who were diagnosed with esophageal atresia, were included in the study. All cases were randomly allocated in two groups: group A (case group) in which patients underwent surgery with preservation of the Azygos vein and group B (control group) in which patients underwent the former surgical method with ligation of the Azygos vein. Incidence of early complications, duration of surgery, and NICU and hospital stay were compared between the two groups. None of the complications occurred in either group. Duration of surgery, NICU stay, and hospital stay were not statistically significant between the groups. Preserving the Azygos vein during esophageal atresia surgery is probably a good modification of the classic technique. [ABSTRACT FROM AUTHOR]

Background: Congenital chyloperitoneum is an uncommon clinical condition. A few cases of congenital chyloperitoneum in children have been described who were treated in a variety of methods. Case Presentation: Congenital chyloperito was diagnosed in a 5-day-old baby boy with a significant abdominal distension. Due to the failed conservative managements by medium-chain triglycerides (MCT) enriched milk and partial parenteral nutrition (PPN), the authors tried platelet rich fibrin glue (PRFG) as an alternative choice which was applied through an already inserted intra-abdominal catheter. PRFG successfully stopped the lymph leakage from all over the small intestinal mesentery; thereby PRFG may be considered as an effective alternative treatment before surgical intervention. Conclusion: Applying PRFG is an easy, safe, and effective alternative option that may be used to close the chylous ascites lymph leakage in children if conservative management with PPN fails. [ABSTRACT FROM AUTHOR]

Introduction: A Nasogastric (NG) tube insertion is a common technique in all neonatal intensive care units (NICUs). In some cases, NG insertion in infants with friable esophageal tissues may lead to some adverse side-effects, although such problems are not commonly seen. Esophageal perforation is a rare but known complication associated with this procedure. Methods: An infant (first child), weighing nearly 2800 gr, underwent elective surgery on the first day of his life; there was no maternal history of diseases and the fetus was born in 39th week of pregnancy. The NG tube was first inserted in the NICU, and the tube, which enters the esophagus at around 5 cm of esophagus, hit a hurdle Results: Simple radiography of thorax was performed after tube insertion, and the tube was detected in the first intra rib; esophageal atresia was suggested. Conclusion: Conservative management in an otherwise uncomplicated case can result in complete recovery in most affected neonates. This case highlights the fact that esophageal perforation can happen due to procedures such as NG tube insertion. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to evaluate preoperative anxiety and its predisposing factors in a group of adult patients who were candidate for any kind of heart surgery. Methods: We evaluated preoperative anxiety in 300 patients undergoing heart surgery whose ages ranged between 18-65 years. Relationship of probable demographic factors like gender, educational level, marital status, number of children, family support, opium addiction, occupational status, and left ventricular ejection fraction (LVEF) with anxiety level of the patients were evaluated. To determine anxiety, the State-Trait Anxiety Inventory (STAI) was completed by the subjects. Results: Descriptive anxiety levels showed that mean of state and trait anxiety of our studied patients were in moderate scaling. Correlation between state and trait anxiety was more prominent in females (r = 0.80) than in males (r = 0.70) (p < 0.001). Distribution of males and females was significantly different (p = 0.048). All the patients had significantly different underlying diseases (p = 0.018), opioid addiction (yes/no) was significantly different in all of the patients (p < 0.001), while family support (yes/no) was not significantly different in all of the patients (p = 0.453). There were significant differences between mean of preoperative anxiety at different LVEF values of any EF level (p < 0.001, F = 6.47); those who had LVEF of more than 50% had significantly lower mean anxiety scores. Conclusion: Preoperative psychiatric consultation should be focused more on women and patients with higher EF. Moreover, physical activity strength may be effective on reducing preoperative anxiety. [ABSTRACT FROM AUTHOR]

Background: Hypotension during spinal anesthesia is common and can lead to severe injuries and even death. Administration of crystalloid fluids is advised to prevent occurrence of hypotension; however its effectiveness is still the matter of arguments., Objectives: This study was designed to compare the effects of Ringer`s lactate and hydroxyethyl starch 6% on hemodynamic parameters after spinal anesthesia in patients undergoing orthopedic surgeries on lower limbs., Patients and Methods: This randomized clinical trial was performed in Rasoul Akram Hospital, Tehran, Iran. 60 patients undergoing elective femoral fracture surgeries with spinal anesthesia were included in this study. Fitted patients were randomly divided into two equal groups. After entrance to the operation room and before spinal anesthesia, patients' hemodynamic parameters including systolic blood pressure (SBP), cardiac output (CO), and cardiac index (CI) were evaluated using monitoring electro-velocimetry set. In both groups, spinal anesthesia was performed using needle no. 25 and 3 mL of marcaine 0.5% in the sterile situation. None of the treatment group was aware of investigated group during the study., Results: The baseline values of mentioned variables did not show a significant difference between two groups using t-test (P > 0.05). Also SBP, CI, and CO after intervention was not significantly different between two groups using t-test (P > 0.05)., Conclusions: The result of present study on patients undergoing femoral fracture surgeries who received Hetastarch or Ringer`s lactate solutions showed that Hetastarch was not significantly more effective in compensation of hypotension induced by spinal anesthesia.