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Abstract 87 . SUMMARY 1J\1D CONCLUSION In this essay atrial to review the different aetiological factors resulting in iatrogenic complications following surgical procedures is settled. This review included iatrogenic complications following head, neck, breast and gastero-intestinal surgery, in addition to iatrogenic complications in anaesthesia and adverse reactions to somedrUgs used in surgery. If we start with head and neck surgery, someiatrogenic complications appear as necrosis of skin flaps, haemorrhage,carotid artery belowout, air embolism, oedemaof ·the face, pneumothorox,esophageal injury, injury to carotid vessels, injury to large lymphatic ducts, facial nerve injury, vagus nerve injury, accessory nerve injury and injury to recurrent laryngeal or supperior laryngeal nerve. While in breast surgery, the examples of iatrogenic complications are, extension of skin incision into the hollow of the axilla, buttonholes in the skin flap, local recurrance, unilateral pneumothorax, bleeding from perforating. vessels, oedema. of the arm, inadequate drainage of breast abscess, injury of intercostobrachial, long thoracic and thoracodorsal nerve. Also, someiatrogenic complicationlil 88 appear in biliary tract surgerY as bile leakage ,subcapsular l;I.aematQmofathe liver, cnoledochoduodenal fistula, pancreatitis, jaundice aDdhepatic artery injury or ligation. With respect to splenic surgery, the examples of iatrogenic complications are,haemorrhage, gasteric fistula, pancreatic injury, aDdtrauma to the left copula of the diaphragm. Also, gastero-intestinal surgery have a great numbers of iatrogenic complications as esophageal stricture or perforation,chylOthorax, fecal fistula peritonitis, injury of the bowel during dissection of adhesion, infarction of intestine by ’application of non-crushing clamps in straight manner, anastomotic leakage, e:x;posureof mucosaat anastomotic line, occlusion of anastomotic site, perforation of the colon during colonoscopy, duodenal stump leakage, necrosis of stomachwall and ulcer recurrance. During anaesthesia someiatrogenic complications mayappear as injury to lips, mucosaof the pharynx, tongue during intubation, misplacement of endotracheal tube, inadequate anaesthe sia, interchange of syring, bacterial meningitis and epidural abscess after spinal anaesthesia. Also, headache, difficulty in hearing and vision me,yoccur after spinal anaestl;l.esia, while , 89 ~teravenous injection of local anaesthetic agents_may . lead .no serious system1c effects.’ .Also, many adverse. reactions of the drugs may appear such as gastero-intestinal haemorrhage. gasteric ulceration, perforation of peptic ulcer, pancreatic necrosis,’ paralytic ileus, interavscular clotting, haemolytic anaemia, aplastic anaemia, megaloblastic anaemia and granulocytopenia. Since the advances in diagnostic and therapeutic tools over the last 30 years have lead definetly to a significant decrease in both morbidity and mortality, however still the iatrogenic complications need the skill and ’care of the surgeon rather than the use of special instruments or methods. We can conclude that, the surgeon is a controlled wise decision rather than a sole techniqual e:x;perience. So, good assessement of pre-operative preparation, proper choosing of the type of surgical intervention, study all the anatomic details and post-operative observations are essential in all surgical procedures. All of these with the gained e:x;perienceof the surgeon are mandatory to avoid iatrogeni.c complications., for the sake of good results. |