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Introduction: This report aimed to analyze the outcomes of patients with obesity who were on a bariatric program during the SARS-Cov-2 pandemic outbreak and compare those who received surgery with the ones who were not operated on. Methods: This was a retrospective study between 2020 and 2021. Patients were divided into two groups: those who underwent surgery (O) and those who were not operated (NO). The evolution of the risk factors identified for severe COVID infection and death was studied (ASMBS criteria). For this study, a follow-up period of 12 months was initiated. Results: In the O group, 83 patients were included and 99 were in the NO group. In the O group, patients with body mass index (BMI) > 35 Kg/m2 before surgery resolved the condition in 73.5% (61) cases, and this was done in the first 30 days by 38 (45.7%). Type 2 diabetes mellitus remission was documented in 18 patients (85.7%) of the O group, and the mean time elapsed for remission was 102.2 days (P <.01). Hypertension remitted in 66.7% (20) of the patients in group O in 82.4 days (P <.01). The subgroup of patients with obesity and one high-risk associated condition (30.2%, 25) resolved both in 44% (11) cases and one in 48% (12) cases. In the group of patients with obesity and two high-risk associated conditions (15.6%, 13), 47% (6) patients resolved the three conditions, 38% (5) resolved two conditions, and 15% (2) resolved one condition. Among the NO group, no comorbidity resolutions were recorded (P <.01). Admission because of COVID infection was necessary for 7.1% of NO and 1.2% of O (P =.04). Conclusion: Bariatric metabolic surgery would not increase the risk of COVID infection or of suffering serious complications resulting from it. Patients undergoing bariatric metabolic surgery rapidly resolved high-risk comorbidities and had less need for hospitalization because of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

One of the most popular procedures amongst obesity surgery is the sleeve gastrectomy. There is international consensus regarding the usage of bougie for sleeve gastrectomy calibration. Nevertheless, there is a dissociation between the number of oesophageal perforations reported for any other oesophageal/gastric operation that requires bougie (e.g., anti-reflux surgery, incidence 1.2%) and bariatric surgery, where this complication seems to be almost a myth. Interestingly enough, the number of bariatric procedures is much higher than any other oesophageal/gastric surgery. This suggests that oesophageal perforations in obesity surgery are underreported. We report a case of injury of the intrathoracic oesophagus with bougie that occurred during a sleeve gastrectomy. In the infrequent case that the perforation is diagnosed during surgery, primary repair during the same intervention is highly recommended. Videothoracoscopy might be an effective option in case of necessity. We were able to complete the sleeve gastrectomy without increasing morbidity.

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Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Evaluar la reproducibilidad y la seguridad de un programa de cirugía colorrectal laparoscópica en dos centros de Sudamérica., Método: Se realizó un estudio analítico-descriptivo. Se revisaron retrospectivamente los registros clínicos de pacientes sometidos a cirugía videolaparoscópica colorrectal desde el año 2012 hasta el año 2018, en dos centros académicos de tercer nivel argentinos. Se analizaron datos demográficos, indicaciones y tiempos quirúrgicos, tasa de conversión, evolución posoperatoria, morbimortalidad y resecabilidad oncológica, y se comparó con el abordaje convencional., Resultados: Se realizaron 505 cirugías. La edad media de los pacientes fue de 63.4 años y el 50.9% eran hombres. El tiempo operatorio medio fue de 175 minutos. La principal indicación fue cáncer de colon. La incidencia de conversión fue del 9.5%. El promedio de ganglios por pieza quirúrgica en patología neoplásica fue de 15.9. La morbilidad fue del 35.4%, en su mayoría complicaciones menores. La tasa de fístulas fue del 11.7%. La mortalidad a 30 días fue del 2.5%., Conclusión: La cirugía colorrectal laparoscópica podría representar una opción segura y reproducible en un centro de tercer nivel de un país en desarrollo., Objective: To evaluate the feasibility and safeness of a colorectal laparoscopic program in two centers form South America., Method: We retrospectively review the records of patients who underwent laparoscopic colorectal surgery from 2012 to 2018 in two tertiary care academic centers. Surgical indication, operative time, conversion rate, lymph nodes harvested, surgical margins and complications were analyzed. This results were then compared to the open approach., Results: We collected data from 505 patients, mean age 63.4, 50.9% male. The most frequent indication was colon cancer, mean operative time was 175 minutes. Conversion rate was 9.5%, mean nodes harvested was 15.9 with free resection margins in every case. Morbidity was 35.4% at 30 days, most of them were minor complications. The leak rate was 11.7 %. The 30-day mortality was 2.5%., Conclusion: The laparoscopic approach for colorectal surgery might represent a safe and feasible option in an tertiary care hospital from a developing country., (Copyright: © 2021 Permanyer.)

Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. Recently, many studies have addressed the laparoscopic management of these tumors. The aim of this study was to evaluate the safety and efficacy of laparoscopic atypical gastrectomy in the resolution of these neoplasms. In the period between January 2009 and December 2015, 24 patients with suspected gastric GIST less than 5 cm in size underwent surgery under this approach. Abscense of peritoneal and liver metastases and immunohistochemistry expression of CD117 antigen were considered as inclusion criteria. We retrospectively analyzed clinical and histopathological characteristics, surgical outcomes, postoperative complications and oncological results. Statistical analysis included 14 patients. The mean age was 60 years (10 women and 4 men) and upper gastrointestinal bleeding was the chief complaint for consultation. Conversion to open surgery was necessary in one case and no major complications, readmissions or reoperations were recorded. The mean tumor size was 41 mm with negative resection margin in all samples. The mean hospital stay was 3 days and no tumor recurrences were recorded in 44 months of follow-up. Laparoscopic atypical gastrectomy for gastric GIST is a safe and effective technique with good outcomes in experienced hands.

Background: Metallic stent placing is the first choice in the treatment of malign or benign strictures of the esophagus. Stent migration is a well-known complication of this procedure. We report a case of stent migration in which surgical laparoscopic intervention was used to retrieve it., Methods: An 85 years old man with unsuccessfully endoscopic retrieval of a migrated stent underwent laparoscopic gastrotomy for solution. The patient recovered without incident., Conclusion: This case illustrates that laparoscopic technique can be an optional way to retrieve migrated stents in selected patients.

Morgagni's hernia is a rare congenital disorder, usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. We reviewed the clinical findings of a patient with a Morgagni's hernia, diagnosed and treated in our department. The Morgagni's hernia caused various symptoms in our patient and surgery was performed via laparoscopy. A chest CT-scan established the diagnosis. The hernial defect was closed with a synthetic mesh. Our patients had an uneventful postoperative recovery. We believe that the laparoscopic approach is an effective way of repairing Morgagni's hernia.

Median arcuate ligament syndrome (MALS), or celiac trunk compression syndrome, is caused by extrinsic compression of median arcuate ligament, prominent fibrous bands and periaortic nodal tissue. In many cases is asymptomatic, but it may manifests with symptoms such as postprandial abdominal pain or during exercise, nauseas, vomiting and weight loss. Trough less invasive diagnostic techniques, such as doppler ultrasound for screening and preoperative angiotomograhpy, it is possible to obtain good results, comparable to those with arteriography. Surgical treatment by laparoscopic approach is a safe and effective technique. A symptomatic case that required surgical treatment, a laparoscopic approach, with clinical and imaging improvement after the procedure, is presented.

Omental hernia through the esophageal hiatus is extemely infrequent. Paraesophageal hiatal hernia with omentum in the herniary sac mimics a mediastinal lipomatous tumor and differential diagnosis should be made. This diagnosis requires experience and knowledge of the differences between these two pathologies. In the following study we describe the case of an omental hernia and the characteristics that make it different from other pathologies.

Granulomatous peritonitis due to surgical glove starch is an entity of difficult diagnosis and low incidence. Patients present with abdominal pain, fever and prolonged functional ileus three to four weeks postoperatory of a laparotomy where corn starch as glove's lubricant had been used. In surgical re-exploration both the peritoneum and omentum are widely affected with multiple small white nodules together with peritoneal fluid. Histopathology shows inflammatory tissue with giant multinucleated cells containing bi-refringent cornstarch particles inside. Under polarized light the typical maltese cross appearance of cornstarch is revealed. We present a 54 year old woman admitted with abdominal pain, fever and an unusually prolonged ileus in postoperatory period after a laparotomy. Conventional hysterectomy was performed three months before. At admission, exploratory videolaparocopy was done, in which accidentally distal jejunum was perforated which required laparotomy for enterorraphy. One month after she was re-laparotomized due to persistence of ileus. Granulomatous peritonitis was evidenciated and confirmed by histopathology. Endovenous hydrocortisone was given during two weeks and shifted to oral prednisone during four weeks with gradual diminution until suppression. Patient is asymptomatic at seven months of postoperatory. Corticosteroid treatment is an efficient choice. The prevention is crucial and is based on the employment of starch free surgical gloves.