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Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020. [ABSTRACT FROM AUTHOR]

Background It is well known that bariatric surgery is effective in the long-term management of weight loss and comorbidity improvement. The frequency of revision procedures is increasing, although they are known to be less effective and are associated with complications. Patients and methods This study was conducted at the Gastrointestinal Surgery Center of Mansoura University, Egypt, aiming to evaluate the indications, efficacy, and safety of reoperative bariatric surgery. We retrospectively reviewed the data of all patients who underwent reoperation for a bariatric-related cause during the duration between December 2012 and October 2021. A total of 90 reoperative bariatric surgeries were done during the study period. Patients had undergone revisional surgery for either insufficient weight loss or refractory complications such as gastroesophageal reflux. Results When comparing insufficient weight loss group and refractory complication group r, our results showed the following finding: a significant difference was noted between the two groups regarding age, the interval between both operations, weight and BMI at both primary and redo operations, ΔBMI and % excess weight loss at reoperation, the laparoscopic approach of both primary and reoperation, postoperative hospital stay, and physical and mental quality of life. The most commonly failed primary operation was sleeve gastrectomy (SG). The most frequent primary operation in the leakage group was SG. The second most common failed primary operation was vertical band gastroplasty. Mini-gastric bypass was the most common primary operation in the malnutrition group (80%), vertical band gastroplasty was the most common primary operation in the stricture group (57%), and SG was the only primary operation in the gastroesophageal reflux group (100%). Conclusion Reoperative procedure should be based on the primary operation, the patient’s anatomy, the patient’s weight and comorbidities, and the experience of the surgeon. [ABSTRACT FROM AUTHOR]

The study evaluates the ability of osteoprogenitors treated with platelet-derived growth factor BB (PDGF-BB) delivered on vinyl styrene microbeads (VSM) to regenerate rat calvarial critical-size defects (CSDs). Fetal rat calvarial cells were cultured and tested for their ability to attach to VSM using scanning electron microscopy. Twenty-five rats were equally divided into 5 groups; a negative control (GPI), vinyl styrene microbeads (GPII), PDGF-BB (GPIII), VSM plus osteoblastic progenitors (GPIV), and VSM plus PDGF-BB treated osteoblastic progenitors (GPV). CSDs were created and reconstructed according to the mentioned study design. After 16 weeks, animals were sacrificed and defect areas evaluated for bone regeneration. Cells attached to the microbeads; however, their morphology and topography were affected by the PDGF-BB. Transplanting the VSM/cells constructs to CSDs revealed significant reduction of bone regeneration upon pretreatment of the cells with PDGF-BB. However, short-term application of PDGF-BB to CSD stimulated bone regeneration. The ability of osteoprogenitor cells to regenerate bone was significantly reduced upon pretreatment with PDGF-BB in vitro. However, adding PDGF-BB at the time of surgery had stimulated bone regeneration. [ABSTRACT FROM AUTHOR]