Background Hartmann's procedure (HP) is used in surgical emergencies such as colonic perforation and colonic obstruction. “Temporary” colostomy performed during HP is not always reversed in part due to potential morbidity and mortality associated with reversal. There are several contributing factors for patients requiring a permanent colostomy following HP. Therefore, there is still some discussion about which technique to use. The aim of this study was to evaluate perioperative variables of patients undergoing Hartmann's reversal using a laparoscopic and open approach. Methods The multicenter retrospective cohort study was done between January 2009 and December 2019 at 14 institutions globally. Patients who underwent Hartmann's reversal laparoscopic (LS) and open (OS) approaches were evaluated and compared. Sociodemographic, preoperative, intraoperative variables, and surgical outcomes were analyzed. The main outcomes evaluated were 30‐day mortality, length of stay, complications, and postoperative outcomes. Results Five hundred and two patients (264 in the LS and 238 in the OS group) were included. The most prevalent sex was male in 53.7%, the most common indication was complicated diverticular disease in 69.9%, and 85% were American Society of Anesthesiologist (ASA) II‐III. Intraoperative complications were noted in 5.3% and 3.4% in the LS and OS groups, respectively. Small bowel injuries were the most common intraoperative injury in 8.3%, with a higher incidence in the OS group compared with the LS group (12.2% vs. 4.9%, p < 0.5). Inadvertent injuries were more common in the small bowel (3%) in the LS group. A total of 17.2% in the OS versus 13.3% in the LS group required intensive care unit (ICU) admission ( p = 0.2). The most frequent postoperative complication was ileus (12.6% in OS vs. 9.8% in LS group, p = 0.4)). Reintervention was required mainly in the OS group (15.5% vs. 5.3% in LS group, p < 0.5); mortality rate was 1%. Conclusions Laparoscopic Hartmann's reversal is safe and feasible, associated with superior clinical outcomes compared with open surgery.

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Resumen En el campo de la medicina las redes sociales han ganado poco a poco terreno y hoy en día juegan un rol importante en el aprendizaje y la enseñanza de conocimientos que se pueden trasmitir de inmediato y de forma masiva. El objetivo de este artículo es mostrar la experiencia colombiana en el uso de las redes sociales para crear aprendizaje quirúrgico significativo, con liderazgo y tutoría global. Se llevó a cabo un estudio descriptivo retrospectivo desde la creación de nuestras redes sociales en Twitter, 22 de febrero al 22 de agosto de 2019, evaluando las siguientes variables: número de tweets académicos, número de seguidores, impresiones, visitas y menciones. Desde la creación de nuestra red social Twitter @Cirbosque para realizar educación virtual quirúrgica a través de redes sociales con el fin de generar un aprendizaje significativo en nuestros seguidores, en solo seis meses del proyecto, seguimos a 62 cuentas, hemos realizado hasta la fecha 5.025 tweets académicos, con un crecimiento del 77,1% mensual, con 2.203 seguidores, con un crecimiento del 426 seguidores mensual, 1.090.000 impresiones, con un crecimiento del 56% mensual, 13.500 mil visitas, con un crecimiento del 28,9% mensual y 2.028 menciones, con un crecimiento del 88,3% mensual. Aunque la evidencia aún es insuficiente para garantizar que la educación que se hace a través de redes sociales y de @Cirbosque sea eficiente, el impacto que ha tenido esta iniciativa en Twitter es apreciada por muchos cirujanos a nivel mundial incluyendo a grandes maestros referentes en cada uno de los temas que se han tratado, de la misma forma, la cantidad de participantes en las diversas discusiones planteadas día a día y con un incremento en todos los indicadores de impacto según Twitter Analytics, se puede deducir que el mensaje educativo está teniendo un efecto positivo y está llegando a miles de personas a nivel mundial.

Since November 2019, the COVID-19 Pandemic produced by Severe Acute Respiratory Syndrome Severe Coronavirus 2 (hereafter COVID-19) has caused approximately seven million deaths globally. Several studies have been conducted using technological tools to prevent infection, to prevent spread, to detect, to vaccinate, and to treat patients with COVID-19. This work focuses on identifying and analyzing machine learning (ML) algorithms used for detection (prediction and diagnosis), monitoring (treatment, hospitalization), and control (vaccination, medical prescription) of COVID-19 and its variants. This study is based on PRISMA methodology and combined bibliometric analysis through VOSviewer with a sample of 925 articles between 2019 and 2022 derived in the prioritization of 32 papers for analysis. Finally, this paper discusses the study’s findings, which are directions for applying ML to address COVID-19 and its variants.

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Introducción. La hernioplastia con malla de polipropileno es la técnica de elección para el reparo de las hernias inguinales. Actualmente, existe controversia sobre esta técnica en pacientes con heridas sucias o contaminadas; sin embargo, la evidencia en la literatura médica ha demostrado que su uso puede ser seguro. Los autores presentan su experiencia con las mallas de polipropileno en la cirugía contaminada para cierre de hernias inguinales. Método. Se realizó un estudio observacional retrospectivo en el que se incluyeron los pacientes mayores de 18 años atendidos entre enero de 2017 y diciembre de 2018 por presentar hernias inguinales, que requirieron tratamiento quirúrgico de urgencias, y que presentaban heridas sucias o contaminadas. Los criterios evaluados fueron: infección de la herida quirúrgica, morbilidad y mortalidad, necesidad de remoción de la malla y recurrencia de la hernia. Resultados. Diez pacientes fueron sometidos a cirugía de urgencias, requiriendo resección intestinal por necrosis: nueve de ellos, por hernias estranguladas y, uno, por apendicitis perforada. En uno de los diez pacientes, se consideró sucia la herida por presentar necrosis intestinal y perforación. Los nueve restantes presentaban necrosis intestinal sin perforación, por lo cual se consideraron heridas contaminadas. La infección de la herida ocurrió en 1/10 pacientes con infección del sitio operatorio superficial; la eliminación de la malla no fue necesaria en ningún paciente durante todo el período de estudio. No se observaron recidivas y no hubo mortalidad. Conclusión. El uso de malla de polipropileno para la corrección de hernias inguinales, en pacientes con heridas sucias o contaminadas, es efectivo y seguro, con una morbilidad aceptable y buenos resultados a corto plazo.

Background: Laparoscopic surgery has changed many ways in which we as surgeons manage patients, offering better results, quicker recovery, and fewer complications using minimally invasive techniques, especially in common bile duct (CBD) surgery. Not only can laparoscopic techniques be applied to programed surgery but also emergencies and those following failed endoscopic retrograde cholangiopancreatography (ERCP). Objectives and aims: Describe and compare clinical and surgical results of the laparoscopic CBD exploration with primary closure using a 3-port vs multiport approach. Materials and methods: We present a multicentric comparative study of 197 consecutive patients who underwent a laparoscopic gallbladder removal along with CBD exploration with primary closure following failed (ERCP to extract CBD stones; 104 patients were managed by threeport vs 93 multiport laparoscopic surgery in five centers of Bogotá, Colombia, between 2013 and 2017 with follow-up of 1 year. Results: A total of 197 patients were taken to laparoscopic gallbladder removal along with CBD exploration with primary closure, 104 patients via three-port technique and 93 patients via multiport. All (100%) the patients had previously failed ERCP. The average surgical time on the three-port approach was 106 minutes vs 123 minutes on multiport. Only in the multiport technique we had an average conversion of 2%. Mean hospital stay of 2.5 days, less for the three-port approach vs multiport in 5-7 days. There was a need of reintervention in 1% of the patients who underwent three-port exploration. Conclusion:Postoperative pain, use of an additional port, complication rates, operation time, and cost of the three-port technique were similar to those of the conventional approach. Large randomized controlled trials are needed to examine the true benefits of the three-port technique.