نشریه جراحی ایران
سال سی و یکم شماره 2 (تابستان 1402)

Cardiovascular diseases are the main cause of death worldwide, mostly due to coronary artery disease. This problem is caused by the narrowing of the arteries due to the accumulation of plaques and thus restricts the blood flow, which causes angina or a heart attack. In order to solve this disease, advanced stents have been designed and produced. The aim is to give an overview of cardiovascular stents from their initial appearance as simple and relatively crude structures and finally to multifunctional devices that provide the possibility of functionalizing the surface of the stent with biological agents through cell stimulation and special technologies. This study reviews various types of permanent and biodegradable coronary stents and developed stents that have been adopted by functionalizing the stent with proteins or growth factors.

Laparoscopic cholecystectomy is a standard procedure for cholecystectomy, although there are fewer complications in this method, but complications such as intestinal and bile duct damage may result in lethal consequences. In this study, in order to identify and take appropriate measures to reduce these injuries during surgery, as well as timely diagnosis and treatment, it has been investigated the prevalence of intestinal injuries in patients who underwent surgery with this method.

In this cross-sectional study, 1223 patients underwent laparoscopic cholecystectomy in hospitals affiliated to Babol University of Medical Sciences in 2007-17. Demographic and clinical data were evaluated. The data was entered into the SPSS software version 23 and was analyzed with Fisher exact and t-test. The significance level was less than 0.05.

The majority of patients, 1051 (85.9%) were women. The age of 386 patients (31.6%) was over 50 years old. The majority of patients, 829 people, equivalent to 67.8%, had chronic cholecystitis. The average and standard deviation for the duration of surgery was 33.26±10.52 minutes and for the duration of hospitalization was 1.10±0.52 days. The prevalence of intestinal damage in patients was generally 0.6% (7 cases). There was a significant relationship between intestinal damage and age, longer hospitalization and longer surgical duration. Most of the patients with intestinal damage had previous history of abdominal surgery and intra-abdominal adhesion.

The prevalence of intestinal damage in patients with laparoscopic cholecystectomy was low and this damage was significantly associated with the age of the patients. The most common findings were intestinal injuries of the intra abdominal adhesions and the history of previous abdominal surgery. Therefore, it is recommended that surgeons should be more careful or patients should preferably undergo open cholecystectomy surgery in these cases.

Since neoadjuvant chemotherapy affects the immune and endothelial systems, and this issue may lead to a delay in surgical wound healing and the occurrence of surgical wound complications, and since there is no detailed information in this regard, The present study was conducted as a meta-analysis with the aim of investigating neoadjuvant therapy on complications caused by surgical wound after mastectomy.

PubMed, EMBASE and Cochrane Library, Web of Science, Science Direct, Scopus, Mag Iran and SID databases with the help of keywords mastectomy, breast surgery, total breast removal, neoadjuvant therapy, neoadjuvant chemotherapy, wound, complications, wound Surgery and breast cancer without time limit were carefully searched in this systematic review and meta-analysis.

14 studies (13 cohort and 1 case control study) with 2198 people were evaluated in this study. The results indicated that the administration of neoadjuvant chemotherapy is not associated with a significant increase in the risk of this complication; In other words, neoadjuvant chemotherapy does not lead to wound complications after surgery (RR = 1.15 - 0.92 - 1.44: 95% CI, P = 0.22 and I = 0% I2).

Neoadjuvant chemotherapy is not related to surgical wound complications after mastectomy; Due to the quality of the articles in this study, the results of this study should be used with caution.

Internal evaluation is a systematic process to collect and analyze information in order to determine the advantages and disadvantages of a program and the degree of achievement of its goals. The purpose of this study was the internal evaluation of general surgery in Kermanshah University of Medical Sciences.

This cross-sectional study was conducted in the General Surgery Department of Kermanshah University of Medical Sciences in 2021. First, data related to 9 areas of internal evaluation (educational mission and goals, management and organization, teaching program, students, education resources, research, assessment and evaluation, and graduates) were collected through checklists and questionnaires. Then, the status of the groups was determined in nine areas of internal evaluation. The results were statistically analyzed using STATA-14 software with an emphasis on descriptive statistics.

The results showed that the condition of most areas in the general surgery group was favorable. The highest desirability was in the area related to educational resources (space, educational and therapeutic facilities and equipment) (98.1%). Also, in the field of research, they obtained a semi-optimal status (71.8%).

In cases with a favorable situation, the group should try to maintain and improve more in accordance with the progress of science and technology, and to improve the factors that did not have a high score in the internal evaluation, review and plan carefully. Also, the university administrators should provide the necessary conditions and resources to improve the condition of the group and achieve the best level with effective support and assistance.

Acute pain after arthroplasty of the lower limb has adverse effects on the patient's treatment aspects, and also considering that acute pain (within the first 24 hours) after surgery is the basis of chronic pain and disability after surgery. and on the other hand, due to the lack of a meta-analysis study regarding the effects of pregabalin on the intensity of acute pain after lower limb surgeries, the present study aimed at the preventive effects of pregabalin on the intensity of acute pain during the first 24 hours after orthopedic surgeries The bottom is done.

This meta-analysis was performed following the guidelines of the PRISMA statement; Studies were selected based on the PICO criteria. Keywords pain, pain intensity, acute pain, pregabalin, lower limb, lower limb orthopedics and analgesia were searched in PubMed, EMBASE and Cochrane Library, Web of Science, Scopus, Mag Iran and SID databases; Statistical analyzes were performed using RevMan 5.4 software.

Pain intensity in the second (MD = -0.26 - CI95% = -0.02 to -0.50 and P = 0.04) and sixth (MD = -0.30 -CI95% = -0.29 to -0.30 and P = 0.00001) and the twelfth (MD = -0.53 -CI95% = -0.29
to -0.78 and P = 0.0001) after surgery was significantly lower in the intervention group than in the control group.

This meta-analysis supports the use of pregabalin before surgery in patients undergoing lower extremity orthopedic surgery and by reducing the intensity of acute pain (pain during the first 12 hours after surgery).

The epidemic of COVID19 in Iran has wide-ranging effects. The impact of the disease on medical education led to the closure of universities and the restriction of treatment to emergency interventions. With the closure of university classes, online and distance education became more widespread. This study examines the quantity and quality and effectiveness of online training in the postgraduate course of plastic surgery.

The present study is a descriptive-analytical cross-sectional study that was approved by the Medical Ethics Committee. In this study, the satisfaction of residents and professors of the Department of Reconstructive and Plastic Surgery in terms of quantity and quality of virtual education classes was examined. For this purpose, a questionnaire and quantitative information about class time and participation rate based on available documents and class videos were used.Data analysis was performed using SPSS software version 22. The frequency of qualitative variables was measured as percentage and ratio and the frequency of quantitative variables was measured by calculating the mean and standard deviation.

The results of the study in ten domains include: the use of teaching aids in the virtual education process, the possibility of participants' access to educational resources, review of interaction and mutual participation, satisfaction with class time, access to the class for participants, evaluation methods and tests Virtual access to out-of-class teachers, satisfaction with the teaching method, satisfaction with the content presented in the class and general satisfaction with the virtual education course were evaluated and showed that in all cases virtual education with a statistically significant difference accepted by group members Is located.

Given corona disease persists and similar diseases may occur in the future, and given that our study recommends the appropriateness of e-learning, it is better to have this method taught and used on a larger scale.

Penetrating trauma to thoracoabdominal area can cause diaphragmatic injury. Diagnostic Laparoscopy is an acceptable method for evaluating the diaphragmatic injuries. Due to insertion sites of ports in classic diagnostic laparoscopy, evaluation of diaphragm behind liver and spleen needs more experience. In patients with suspicious to diaphragmatic injury and according to available facilities in our centers, we suggest that in unilateral injuries instead of contralateral midclavicular 5mm port, insert a 5mm port in subxyphoid area. In bilateral injuries, if enough exposure doesn’t achieve, we can add a 5mm port in subxiphoid area. In bilateral injuries, if enough exposure doesn’t achieve, we can add a 5mm port in subxiphoid area. In absence of 30 degrees cameras, use of 10mm port in subxiphoid can give surgeons better exposure of diaphragm with zero-degree cameras.

Metaverse is a digital reality that allows humans to interact with other people or digital characters, Metaverse technology. It has significant potential in medical sciences and pharmaceuticals. For many years, it has been providing medical services to patients such as patient diagnosis, medicine or surgery through direct communication between the doctor and the patient. Medical training can normally be better aided by the use of surgical equipment in areas that require advanced manual skills. Using Metaverse in surgical training allows the trainee to perform procedures on an authorized patient or match patient information to reality. The discovery of the Internet and the digital space made it possible to provide medical services and connect the patient with the doctor through electronic devices. It has made it easier to navigate through these services. Performing surgery with the help of robots has a high potential to move towards permitted realities. One of the best ideas to benefit from Metaverse is digital therapy. If the metaverse technology is accompanied by real innovation to evaluate people's perceptions and expectations, it will revolutionize health care in the near future. Using its innovative and licensed exclusives, Metaverse offers previously unimaginable facilities and services in the field of digital health, Metaverse can be a simulator where surgeons are one in the same as they are performing surgery, Meet the other. Undoubtedly, medical progress in the future and the existence of metaverse technology will be followed by significant changes.