Iranian Journal of Surgery
Year:2018 | Volume:26 | Issue:3 |Papers Count:11

Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. Blunt chest trauma and related complication is associated with 25% mortality. Lung contusion is one of the most dangerous complications of blunt chest trauma and occurs in 25-75% of all blunt chest traumas. PubMed, Elsevier and Medline search with two keywords, lung contusion and chest trauma, was done till 2016 for the most important questions. Despite of decrease in the prevalence of lung contusion, the mortality and morbidity of this entity have not been improved during the last decades, due to misunderstanding of pathophysiology.

Introduction & Objective: Low Back Pain (LBP) is among the most common causes for pain and disability to do different tasks. Also, it is one of the common reasons for medical appointments. Magnetic Resonance Imaging (MRI) is a suitable method to diagnose and assess muscular atrophy and lack of attention to atrophy may lead to lack of back pain diagnosis. The objective of the present study is to examine the relationship between muscular atrophy and its severity with pain and disability in patients. Materials & Methods: This analytical cross sectional study was conducted on 288 people above 20 years old during 2016-2018 on three groups (n = 96) including healthy people (control group), people with LBP and people with lumbar discopathy. Parameters of interest in patients included atrophy severity, ratio between CSA of psoas muscles and intervertebral disk (PS: Disk), the ratio of erector spinae muscle and intervertebral disk (Er: Disk), the ratio between multifidus muscle and intervertebral disk (MF: Disk), pain, and anxiety. Results: The ratio of PS: Disk, Er: Disk, and MF: Disk was significantly lower in LBP group. The prevalence of moderate fatty atrophy was significantly higher in LBP group (96. 23%). This was not significantly different from other groups of the study. Average Oswestry Disability Index (ODI) was significantly higher in lumbar discopahy. Also, ODI in LBP group as significantly larger than healthy people. Pain duration, axial LBP, and anxiety in LBP group were significantly larger than other groups. Conclusions: According to the results, LBP and para-spinal muscle atrophy in patients with LBP were larger in patients with LBP compared with patients with lumbar discopahy. CSA in patients with lumbar discopahy and healthy patients showed no significant difference. ODI and disability in patients with lumbar discopahy (24. 5 ± 67. 164) were larger than other groups.

Introduction & Objective: Trauma is the most common cause of mortality in young people, and spinal fracture and cord injuries are associated with early and late social and economic consequences and lead to permanent disabilities and reduced life expectancy. The aim of this study was to evaluate the spinal canal damage and its associated traumatic injury in patients referring to trauma referral hospital at the age of 10 years. Materials & Methods: 680 patients who were referred to the university hospital with spinal fractures based on case studies and imaging were included in our study. All patients were ICD10 classified according to the ICD10 classification between 2015 and 2016. Age, sex, traumatic mechanism, traumatic injury and fracture type date demographically analyzed. Results: Among 522 patients examined, the incidence of male to female was 2. 3 to 1 and it was between the age ranges of 21 to 45 years. Traffic accidents and falls were the most common causes of fracture. In addition, the most common fracture site was thoracolumbar region (T11-L2) and injury to the head, lower extremity and chest wall were the most common coexisted injuries. Conclusions: There was no relationship between the factors affecting external spinal injuries with age and gender, but there was a significant relationship between the cause of the accident and the factors affecting non-spinal injuries. The distribution of fractures per spine in terms of Frankl's classification and AO criteria has a significant relationship with each other. There was a significant relationship between Frankl's classifications in AO criteria.

Introduction & Objective: In recent years, scientific publications related to the rights of patients, especially in surgery, have been greatly improved. In this regard, the aim of this study is to review the scientific production of patients’ rights related to the field of surgery around the world. Materials & Methods: This research is a scientific research that was carried out using ISI database and embedded analysis engine in it. Also, Excel software was used to draw tables. Results: The findings of this study showed that the United States, Germany and the United Kingdom ranked first to third in this regard. Also, the largest scientific publications in this field belongs to the Sao Paulo University, which is ranked first. Ankara Univ, Harvard Univ and Univ Oslo each rank 6 with 6 degrees each. Conclusions: The growth of scientific production in this field around the world is relatively good than before, and the position of Iran, which is eleventh, is appropriate, but in terms of quantity, these products are not impressive and should be in addition to quality and operationality. There are numerous queries and researches that can be used to make good decisions for decision-makers. Therefore, researchers in this field should double their efforts.

Introduction & Objective: Psychological factors as hope of life can reduce or promote cancer progression because of the influence of these factors on the immune system that protected body against illness and may help to fight cancer. The present study investigated the predictability of hope of life based on mental health and psychological hardiness in women with cancer after surgery. Materials & Methods: The population of this study was all women with cancer after surgery who were referred to Cancer Institute of Iran for follow up. 122 patients recruited in this study based on purposive sampling. They completed the validated questionnaires for hope (Snyder, 1991); mental health (Keyes & Magyar-Moe, 2003); and short form of hardiness scale (Kubasa, 1982). Data were analyzed by using Pearson’ s correlation coefficient and hierarchical multiple regression. Results: Findings indicated a significant positive relationship between hope of life and mental health (emotional well-being, psychological well-being and social well-being), as well as psychological hardiness (commitment, control and challenge) in women with cancer (P < 0. 01). Hardiness explained 49. 8% of the variance in hope of life (P < 0. 01) and mental health explained 25. 4% of the variance in hope of life (P < 0. 01). Commitment (P < 0. 05), emotional well-being and psychological well-being (P < 0. 01) predicted hope of life in women with cancer. Conclusions: According to this study, the patients with higher, emotional well-being, Psychological well-being and commitment had greater hope of life. Psychological interventions for strengthening these factors in women with cancer after surgery are suggested.

Introduction & Objective: Cancer is the result of abnormal growth of the cells with the potential to invade or spread to other parts of the body which affects psychological patients’ aspects. Some of mental health disorders in cancer patients are due to lack of psychological flexibility. An assessment tool that can be used on these patients will be helpful to prepare patients not only for surgery but also after surgery. This study aimed to determine the factor structure of the Persian version of acceptance and action questionnaire (AAQ-II) in the cancer patients. Materials & Methods: This study was a cross-sectional study in which 95 cancer patients that admitted to Firoozgar Hospital in Tehran participated in the study. The Persian version of acceptance and action questionnaire (AAQ-II), Heartland Forgiveness Scale (HFS) and Beck Depression Inventory-II (BDI-II) were used to this study. Exploratory and confirmatory factor analysis methods, convergent-divergent validity were used to examine the validity of the study. The internal consistency coefficient was used to reliability. Data analysis was performed in IBM SPSS 22 and Amos 22 software. Results: Exploratory factor analysis by principle component analysis and Varimax rotation indicated that the two factors are extractable from the Persian version of the scale (named as feelings and worries and negative memories) and the fitting indices confirmed the results of the confirmatory factor analysis of the dual factors. Correlation coefficients between the scores with other valid tools, Heartland Forgiveness Scale (HFS) and Beck Depression Inventory-II (BDI-II), showed that the convergence and divergence validity of the scale is acceptable and the Cronbach's alpha coefficient (0. 824) confirmed internal consistency. Conclusions: The Persian version of AAQ-II in cancer patients was resulted two-factor structure, and it seems that it is more appropriate than single-factor structure and suggested. This questionnaire can be used for cancer patients before surgery.

Retained surgical sponges are one of the complications of surgery, especially intra-abdominal surgery. The term gossypiboma denotes a piece of cotton material such as cotton pads, towels and sponges forgotten in a body cavity after operation. The patient was a 74-year-old woman hospitalized for abdominal pain and lump, which revealed that part of the terminal ileum and cecum was an indistinguishable mass, due to fibrotic reaction of the previous gynecologic surgery. Ileocecal resection and ileocolic anastomosis and abdominal lavage were performed and the patient was discharged a few days later. Hence to gossypiboma and its complications are one of the legal matter in medicine, consideration to prevention is important.

Conventional surgery for open thyroidectomy is safe and effective. However, there have been concerns that neck Scarring can be a major source of dissatisfaction after surgery. To eliminate visible scarring on the neck, we successfully present the first attempt of transaxillary endoscopic thyroidectomy in Iran. Two patients were admitted with thyroid nodules in general thoracic surgery ward of Imam Reza hospital, Tabriz, Iran. Endoscopic hemithyroidectomy was performed via a unilateral axilla approach with CO2 insufflation. A 10-mm and two 5-mm trocars were inserted at the anterior axillary line. The patients successfully underwent endoscopic thyroidectomy and tolerated the procedure well without any complications. Endoscopic hemithyroidectomy via a unilateral axilla approach is safe and feasible in selective patients with thyroid disease. To our knowledge, the current study is the first clinical experience with novel technique for thyroid surgery in Iran.