Showing 6 results for Zaman
Valliolah Hassani, Mahzad Alimian, Mohammad Farhadi, Behrouz Zaman, Masood Mohseni,
Volume 1, Issue 2 (11-2012)
Abstract
Background: Surgeon’s depend to a large degree on the amount of blood loss and a clear
view of the surgical field, when conducting endoscopic procedures in order to achieve
satisfactory outcomes. The anesthesiologist’s choice of method for the induction and
maintenance of anesthesia plays a major role in achieving this goal.
Objectives: This study was performed in order to compare the two most well-known
methods in this regard; total intravenous anesthesia (TIVA) and venous inhalational
mixed anesthesia (VIMA).
Patients and Methods: This study included the endoscopic management of 89 patients
with cerebrospinal leakage (CSF leakage) covering a period of nine years (1999-2008) for
whom a subarachnoid injection of fluorescein was first administered, and afterwards
they were maintained under general anesthesia using two distinct methods; propofolremifentanil
versus isoflurane–remifentanil (inhalational or intravenous). During the
operation, hemodynamic indices, blood loss, and surgeon’s satisfaction, were assessed
and compared between the two groups.
Results: Endoscopic management and autografts were successful in repairing anterior
skull defects in 90% of cases. Regarding the surgeon’s satisfaction level, and hemodynamic
stability no significant difference between the two groups was observed (P > 0.01).
Conclusions: Both isoflurane and propofol in combination with remifentanil afford optimal
surgical conditions with regard to hemodynamic parameters and the satisfaction
of the surgeon with the surgical field.
Ahmadreza Soroush, Elham Pourbakhtyaran, Somayyeh Allame, Mohammad Mahdi Zamani, Mehrnoosh Etemadi, Shirzad Nasiri,
Volume 2, Issue 3 (8-2013)
Abstract
Background: Traditional haemostatic techniques in total thyroidectomy may cause some damages to surrounding tissues. It is believed that these damages can be reduced using ultrasonic dissector devices like Harmonic Scalpel (HS). Objective: In this study, we investigated the efficacy of ultrasonic dissectors (HS) versus conventional techniques (Clamp and Tie). Patients and Methods: A single blinded randomized clinical trial was performed at a referral educational center. Sixty eight eligible participants were enrolled and assigned to conventional group (operated with Clamp and Tie technique) and HS group (operated with Harmonic Scalpel). The following items were recorded in both groups: haemostatic technique, operative blood loss, duration of surgery, length of hospital stay, pathology, thyroid weight, postoperative recurrent laryngeal nerve injury, change in calcemia, pain, drainage volume and hematoma formation. Results: The results demonstrated that application of HS in thyroidectomy significantly reduces operating time (P ≤ 0.0001) and Intra operative bleeding (P ≤ 0.0001). Postoperative drainage (P ≤ 0.0001), pain (P ≤ 0.0001), hypocalcemia (P ≤ 0.0001), and length of hospitalization (P ≤ 0.0001) were significantly lower in HS group. Voice score was significantly lower in HS group (P ≤ 0.0001). Conclusions: HS in total thyroidectomy, reduces operating time, blood loss, postoperative pain, drainage volume, voice changes, and postoperative hypocalcemia, compared to conventional techniques.
Najaf N. Siddiqi, Qmar Zaman, Keval M. Patel, Manfred Odermatt, Jim Khan, Amjad Parvaiz,
Volume 4, Issue 3 (8-2015)
Abstract
Background
Previous abdominal surgery and its related adhesions are usually a relative contraindication for laparoscopic surgery or reason for conversion.
Objectives
This study aim to identify patients with previous abdominal surgery and compare the clinical outcomes in patients with and without previous abdominal surgery.
Patients and Methods
Data was collected prospectively from September 2006 to Dec 2010 of all laparoscopic colorectal resections done for both benign and malignant diseases.
Results
Out of 718 patients 476 had no previous abdominal surgery (Group A), whilst 190 patients had previous abdominal surgery not involving colonic surgery (Group B), and 52 had previous bowel surgery (Group C). The conversion rate was 4% for all groups, the re-admission rate was 11.8% for Group A, 12.6% for Group B and 9.6% for Group C, the median length of stay was 4 days for Groups A and B and 5 days for Group C. There was no statistically significant difference between groups for any of the above measures. However, there was a statistically significant difference in the length of operative time between groups. Patients in Group A and Group B requiring a median of 180 minutes, whilst Group C required a median of 210 minutes of operative time. (P = 0.026 and 0.002, respectively).
Conclusions
Previous abdominal surgery, including previous colonic surgery, confers no added risk of conversion to an open operation, morbidity or mortality for patients undergoing laparoscopic colorectal surgery. The operative time however is longer (30 minutes) for patients with previous colonic surgery.
Negar Zamaninour, Atefeh Seifollahi, Abdolreza Pazouki, Ali Kabir,
Volume 8, Issue 2 (Annals of Bariatric Surgery 2019)
Abstract
Background/Aim: One anastomosis gastric bypass (OAGB) is considered as a surgical treatment option for patients with morbid obesity. However, significant decreases in dietary intake and nutrient malabsorption after OAGB may potentially lead to nutritional deficiencies. This study was therefore conducted to assess and compare the mean values of dietary intake over 12 months following OAGB in patients with different pre-operative body mass index (BMI).
Methods: The study was performed on 60 patients with morbid obesity (88.3% female) who underwent OAGB between January 2011 and November 2018. The average daily nutrient intake values were obtained from food frequency questionnaires. Other data were drawn from the National Obesity Surgery Database.
Results: The mean (SD) pre-operative age, weight and BMI were 41.08 (9.41) years, 121.43 (21.01) kg, and 46.77 (6.17) kg/ m2, respectively. Participants were divided into two groups based on their pre-operative BMI (1: BMI≤ 45 kg/m2, n=29; and 2: BMI> 45 kg/m2, n= 31). The mean %EWL at one year postoperatively was 52.37±8.63 and 50.82±8.75 in groups 1 and 2, respectively. However, there was no significant difference in %EWL between groups (P=0.49). Additionally, the percentage of energy consumption from carbohydrates, protein and fats after surgery was 55.49±6.19%, 16.18±2.60% and 32.05±5.97%, respectively. No significant difference was observed in average daily energy and macronutrient intakes between groups (P>0.05 for all).
Conclusion: Pre-operative BMI values probably had no significant effect on post-operative %EWL, nor on energy and macronutrient intake. Large-scale studies are needed to confirm these findings.
Ali Sheidaei, Seyed Amin Setaredan, Fatemeh Soleimany, Kimiya Gohari, Amirhossein Aliakbar, Negar Zamaninour, Abdolreza Pazouki, Ali Kabir,
Volume 8, Issue 2 (Annals of Bariatric Surgery 2019)
Abstract
Background: According to the IFSO worldwide survey report in 2014, 579517 bariatric operations have been performed in a year, of which nearly half the procedures were SG followed by RYGB. This procedure is a proven successful treatment of patients with morbid obesity which induces considerable weight loss and improvement of type 2 diabetes mellitus, insulin resistance, inflammation, and vascular function. In the present study, we aimed to build a machine based on a decision tree to mimics the surgeons pathway to select the type of bariatric surgery for patients.
Material and methods: We used patient’s data from the National Bariatric Surgery registry between March 2009 and October 2020. A decision tree was constructed to predict the type of surgery. The validation of the decision tree confirmed using 4-folds cross-validation.
Results: We rich a decision tree with a depth of 5 that is able to classify 77% of patients into correct surgery groups. In addition, using this model we are able to predict 99% of bypass cases (Sensitivity) correctly. The waist circumference less than 126 cm and BMI equal to or more than 43 kg/m2, age equal to or greater than 30 years old, and being hypertensive or diabetes are the most important separators.
Discussion: The effects of all nodes have been studied before and the references confirmed the relations of them and surgery type.
Dr Negar Zamaninour, Miss Mohadeseh Hassan Zadeh, Dr Abdolreza Pazouki, Dr Ali Kabir,
Volume 10, Issue 1 (6-2021)
Abstract
Background/Aim: Previous studies have demonstrated that patients with obesity can be metabolically healthy. However, little is known about the healthy or unhealthy metabolic status of patients undergoing bariatric surgery. This study, therefore, assesses the prevalence of metabolically healthy (MHO) and unhealthy (MUO) obesity among bariatric surgery candidates.
Methods: The study involved 713 bariatric surgery candidates (580 women and 133 men; age range 18-69 years). MHO and MUO were defined according to The National Cholesterol Education Program-Adult Treatment Panel III (ATP III).
Results: Mean (±SD) patient age, weight, body mass index (BMI), waist and hip circumference were 40.44 (±10.26) years, 127.15 (±22.15) kg, 164.33 (±8.85) cm, 46.90 (±5.79) kg/m2, 122.57 (±13.93) cm, and 140.10 ( ±12.40) cm, respectively. 318 patients (44.6%) were classified as MHO and 395 (55.4%) as MUO. A higher percentage of participants aged 40 years and older suffered from unhealthy metabolic status (61%).
Conclusion: A large percentage of bariatric surgery candidates are metabolically healthy. Additionally, the prevalence of MHO was higher at younger ages
