IRANIAN JOURNAL OF SURGERY
Year:2023 | Volume:30 | Issue:3-4|Papers Count:11

Anatomic and physiologic changes in the maternal trauma patient evolve over the course of pregnancy and requires modifications in management based on gestatinal age. Patient care should be tailored for the anatomic and physiologic changes in gravid trauma patients, but priorities remain the same for the non gravid patient. Relative hypervolemia of pregnancy can mask large volume hemorrhagic losses and requires rapid identification and aggressive resuscitation. Compression of inferior vena cava (IVC) and decreased cardiac output can result from supine positioning, proper positioning and use of wedge is recommended. A kleihauser-Betke test should be performed in all pregnant trauma patients with greater than 12 weeks of gestation and prophylactic anti-D immune globulin given within 72 hours for high-risk patients. Radiation exposure should be minimized in all pregnant trauma patients. Ultrasound including (FAST) exposes mother and fetus to no radiation and is reliable. Angiography and embolization may be useful in life threatening hemorrhage. Pregnant women are at increased risk for deep venous thrombosis (DVT) and should be given unfractionated subcutaneous heparin for prophylaxis. Providers should have a low threshold for screening maternal trauma patients for intimate partner violence (IPV) and substance abuse.

Introduction & Objective: Today, with the spread of the tendency to non-invasive methods, laparoscopic surgery has been used progressively and with acceptable results. The aim of this study was to investigate the effects of carbon dioxide insufflation on hemodynamic parameters in laparoscopic gynecological surgery. Materials & Methods: This cross-sectional analytical study was performed on patients undergoing laparoscopic surgery in Al-Zahra Hospital during 2021. Hemodynamic parameters were recorded before the gas insufflation, after 5, 15, and 30 minutes and immediately and 15 minutes after the gas exsufflation, the data were entered into SPSS software version 19. Results: The trend of changes in hemodynamic parameters including mean SBP, DBP and HR from T0 to T5, was statistically significant which was ascending following gas insufflation and the highest mean SBP, DBP and HR were observed within 15 minutes after gas insufflation (P < 0. 0001). In addition, following the gas insufflation the trend of changes in ET-CO2 values and SaO2 was statistically significant (P < 0. 0001), No adverse events were reported in any of the patients. Conclusions: According to the standard protocols of anesthesia and surgery in this center, laparoscopic surgery was associated with some degree of hemodynamic fluctuation including increased systolic blood pressure, diastolic blood pressure, heart rate and end-expiratory carbon dioxide which was well tolerated by our study population who were in good medical condition.

Introduction & Objective: Since the use of skin flap method is a common method in breast surgery and it may affect the rate of infection after surgery, and since there is no collected information in this field, the present study is a review. A systematic and meta-analysis has been conducted with the aim of investigating the effects of the skin flap method of breast surgery on the incidence of infection after mastectomy. Materials & Methods: This study was conducted as a systematic review and meta-analysis. Keywords skin flap, skin flapping, mastectomy and breast were performed by systematic search based on PRISMA flowchart in all electronic databases (PubMed, Web of Science, Scopus and EMBASE, Mag Iran and SID). Results: The results of the meta-analysis of these 5 studies indicated that the incidence of infection following the skin flap was non-significantly (0. 344-1. 013) CI95%, OR=0. 59 and P = 0. 056) less than not. It was a skin flap. Also, the heterogeneity of the studies indicated the average heterogeneity of the studies (I2 = 41. 99% and P = 0. 141). Conclusions: Several factors affect the incidence of infection after mastectomy, one of which is the use of a skin flap during mastectomy,Based on the results obtained from the present study, the use of skin flap method in women candidates for mastectomy, partially reduces the risk of infection in the surgical area,Due to the heterogeneity of the studies, the results of our study should be used with caution.

Introduction & Objective: The present research has investigated the presence and activity of Iranian authors of cardiac surgery field in Scopus and Web of Science databases. The purpose of this research is to identify the relationship between altmetrics scores in the ResearchGate social network and scientific metrics of Scopus and Web of Science databases. Materials & Methods: This research is an applied research that has been carried out by survey-descriptive method. Scientific method has been used in this research. The research period is from 2010 to 2019. The number of these authors was 147. Due to the small number of the statistical population, sampling was not used and all authors were reviewed. Data collection tools were observation and file extraction of data obtained from Scopus database. In order to analyze the data, Pearson correlation tests and multiple linear regressions were used in Excel and SPSS software. Results: The results showed that in a period of ten years (2010-2019), 485 documents in the field of heart surgery were indexed by Iranian authors in the Scopus database. The studied documents are mostly articles. The language of most documents is English. A survey of Iranian authors of cardiac surgery in the Scopus database identified 147 people. Among the most prolific authors in the field of cardiac surgery, Fereydoun Sabzi with 26 articles has the highest number of indexed articles ever. The highest score of h-index in Scopus database (29) is related to Heidar Ali Talebi. The highest score of h-index in web of Science (31) is related to Mohammad Mahdavi, and the highest score of RG index in ResearchGate (47. 79) is related to Alireza Abdi. Conclusions: In this study, it was found that there is a significant relationship between citation indices, readers, followers, publications, and RJ score in ResearchGate social network with the indexes of publications, citations, h-index and co-authorship in Scopus. On the other hand, there is no significant relationship between the interest score and followers in ResearchGate with the publishing indexes, citations, h-index and co-authorship in Scopus. In this research, it was found that the significance value of the variables of readers, followers, followers, and RJ score in ResearchGate is greater than 0. 05. Therefore, these variables are ineffective in changing the number of citations received in Scopus.

Introduction & Objective: This research was conducted with the aim of drawing a scientific map of collaborative research in the two fields of surgery and chemistry by Iranian researchers using data from the ISI reference database. Materials & Methods: The present research was conducted using documentary method and vocabulary co-occurrence analysis. Also, this research is practical in terms of purpose. The research community consisted of all articles indexed by Iranian researchers in the Web of Science database between 1992 and 2021 in the fields of surgery and chemistry. Also, the desired maps were drawn using VOSviewer software. Results: The results of the thematic map drawing showed that there was a map with 9 clusters in these two areas. Since the points with larger and colored circles mean frequently used categories and hot topics in the field, in these image points categories such as in-vitro, surgery, chemotherapy, composite scaffolds have 73, 55, 44 and 16 occurrences respectively. They form larger circles, so these categories can be considered hot and widely used topics of collaborative scientific productions of these two fields. Examining the results of the countries' participation network showed that 43 countries have had collaborative scientific production with our country's researchers in the two studied areas, therefore, this network has 6 clusters consisting of 442 nodes. Also, the findings about the participation network of organizations showed that in these two fields, 12 universities or organizations participated in collaborative scientific productions in the two fields of surgery and chemistry, this network has 8 clusters. In this network, Iran University of Medical Sciences with 32 links, Iran University of Medical Sciences with 29 links, and Baqiyatullah University of Medical Sciences with 23 links are ranked first to third, and Amirkabir University of Technology is ranked fourth with 17 links. Conclusions: The results showed that 1245 degrees were done collaboratively between researchers in the fields of surgery and chemistry. This number of articles has been cited 46827 times, which shows that these articles are popular.

Introduction & Objective: Neoadjuvant chemotherapy may increase complications after surgery, the incidence of these complications has not been accurately reported,Among these complications, we can mention the duration of surgery and the amount of bleeding during surgery, which are associated with subsequent complications, and there is no accurate information in this field,Therefore, the present study was conducted with the aim of investigating the effect of neoadjuvant chemotherapy on the amount of bleeding and length of surgery in breast surgeries in the form of a meta-analysis. Materials & Methods: This study was conducted as a meta-analysis during 2022,A search using MEDLINE, Embase, the Cochrane Library, Google Scholar, ClinicalTrials. gov and the WHO International Clinical Trials Registry platform to identify studies evaluating the effect of neoadjuvant chemotherapy on complications after breast surgery with the keywords breast cancer/breast neoplasm,neoadjuvant therapy/neoadjuvant chemotherapy,Breast surgery/mastectomy was performed in this systematic review and meta-analysis. Results: Neoadjuvant treatment insignificantly reduces the duration of surgery (95% CI =-22. 42-27. 76, MD = 2. 67, P = 0. 083, I2 = 99%),Also, neoadjuvant treatment significantly reduces bleeding during surgery (95% CI =-107. 44-23, MD =-75. 85, P = 0. 0001, I = 97%) (Figure 1, part B),It should be noted that the heterogeneity of both studies was significantly high. Conclusions: Neoadjuvant chemotherapy with a partial face leads to an increase in the length of the surgical period and significantly leads to a decrease in the amount of bleeding during breast surgery.

Lung cancer is the most common cancer worldwide with over 2. 09 million global cases in 2018. In the United States only, lung cancer led to over 142, 000 deaths in 2019. When diagnosed at early stages, surgical resection may help lung cancer get optimal oncologic outcomes. Generally, surgeons are facing patients with decreased cardiorespiratory reserve and increased postoperative risk of cardiovascular complications when evaluate lung resection candidates. So, cardiorespiratory assessment is a main factor to weigh perioperative risks versus potential benefits of surgery in order to plan optimal perioperative care. The current article describes the ways to limit and control the challenge in terms of preoperative assessment of lung resection cases by evaluating lung mechanics, parenchymal function and cardiorespiratory reserve.

Leading scholars and publishers from ten countries have agreed a definition of predatory publishing. We present an article review leading to a guide for recognition of these journals.

The concept of consent and the theory of innocence are considered as new attitudes and important approaches in medical law, and studying them, as one of the fundamental conditions of medical liability, is of particular importance. Consent to treatment implies that every sane and mature person is entitled to make decisions around the treatment or the treatment method which has been recommended or is necessary for him/her. On this basis, the legislator has explicitly referred to obtaining the consent of the patient or his/her legal representatives in surgical and medical operations, and has considered the presence of such consent and innocence as a must in all surgical and medical procedures, except in necessary and urgent cases. However, given that in the legal system of Iran, following Imami jurisprudence, the pre-operation innocence institution in surgical and medical operations has been taken into consideration by the legislator and is the theoretical basis of medical liability, obtaining the patient’, s consent, the legitimacy of medical operations, and observing technical and scientific standards and governmental systems are not necessarily considered as the physician’, s disclaimer or among the causes of medical malpractice. The physician will be liable to compensate any life or financial losses caused to patients unless he/she has been acquitted of responsibility by the patient or his/her parents before beginning the treatment, and provided that he/she has not committed any faults. Therefore, the analysis of the concept of consent and the theory of innocence in medical law is the issue which has been discussed and analyzed in detail in the present article.