AS remain frequent complications of esophageal surgery, especially in specific subgroups of patients. SI at 1 month after surgery could already predict the severity of the stricture and the need for subsequent endoscopic esophageal dilatations.

3D laparoscopy in small spaces is associated with a significant shorter operating time. It induces no additional physical or psychomental stress in surgeons naive to 3D imaging. 3D may therefore facilitate minimal invasive surgery in neonates and infants.

The management of ARM in Europe is very heterogeneous. High-quality clinical studies are needed to provide scientific evidence for the optimal treatment strategies.

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Facing the emergency of COVID-19 in one of the first red zones in Italy, we would like to remark about the significant impact that this infection brought to our Departments of Pediatric Surgery/Urology in our hospital (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano). We hope that our message will help other hospitals facing this world emergency.COVID-19 infection exploded in China in November 2019, becoming a pandemic infection in March 2020. The majority of the National Health Systems did not expect such a dramatic scenario, but they had to adapt their systems to this new situation. Despite a reduced number of involved patients compared to adults, COVID-19 has brought changes also in the management of the pediatric population.Our System Before the Infection Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico is a general hospital with an area dedicated to neonates, children, and mothers. It counts 900 beds, with a maternal area of 320 beds and 6.000 deliveries per year. All the disciplines are represented in the hospital, including transplants and trauma. There are 58 adult ICU beds and 5 pediatric ICU beds plus 23 neonatal ICU beds.Before the infection, the Departments of Pediatric Surgery/Urology counted on average 3.000 surgical procedures in children per year, with a dedicated area of 28 beds. In the system, specialists dedicated to this assessment are 2 professors, 3 senior consultants, 4 consultants, 2 senior registrars, and 3 registrars. The Paramedic system includes 8 pediatric nurses, 7 general nurses, and 3 healthcare assistants. The departments, being in a University Hospital, count also on 3 fellows and 2 medical students. The system is also provided by dedicated anaesthetists for the area of Maternal-Children activities. All the neonatal surgical cases are admitted in a different dedicated Neonatal Department counting 58 beds (23 ICU).The Maternal-Neonatal-Pediatric Department is one of the largest in Europe. In this department many procedures of fetal surgery are performed. In particular, in our department, the first fetal treatment of spina bifida with minimal invasive approach in Europe was performed in June 2018. It is also one of the 4 departments in Europe for fetal treatment with tracheal plug for congenital diaphragmatic hernia. It is the main Italian referral center for low urinary tract obstructions and vesico-amniotic shunting.The following procedures are offered to neonates, infants, and children: elective surgery for major surgery or routine minor surgery, emergencies, oncology, and neonatal surgery. Patients are prepared with preop evaluation usually 2 weeks before the operation. Minor surgeries (65% of the procedures) are managed with day-surgery, while patients undergoing major surgery are usually admitted the day before for preparation to surgery. Major surgery records a waiting list of 35 days and a

Patient: Male, 48Final Diagnosis: Adrenal oncocytic carcinomaSymptoms: AsymptomaticMedication: —Clinical Procedure: Transabdominal laparoscopic right adrenalectomySpecialty: SurgeryObjective:Rare diseaseBackground:Adrenocortical oncocytic neoplasms (AONs) are extremely rare tumors. AONs are classified as: oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP), and oncocytic carcinoma (AOC). Among the 162 reported cases of AONs in the literature, 30 cases were classified as malignant. Adrenalectomy is the treatment of choice for AON.Case Report:We report the case of a 48-year-old man with a primitive 12-cm mass affecting the right adrenal gland, detected by ultrasonography during follow-up for alcoholic liver cirrhosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass of the right adrenal gland compressing the inferior vena cava (IVC) and dislocating the right lobe of the liver, with no invasion of kidney, liver, or IVC. Preoperative blood tests showed mild transaminase increase. Laparoscopic right adrenalectomy with lateral transperitoneal approach was performed. The postoperative course was uneventful. The lesion was diagnosed as a primitive adrenal oncocytic carcinoma (AOC). No recurrence was evidenced during 24-month follow-up.Conclusions:Although AONs are very rare, they must be considered in the differential diagnosis of adrenal masses due to their prognostic difference compared to non-oncocytic tumors. AOCs are a rare presentation of AONs. Only 30 cases are described in the literature. Laparotomic adrenalectomy is the treatment of choice for AOC. We report the first case of laparoscopic lateral trans-abdominal adrenalectomy for a voluminous AOC (120×95×110 mm) and we review the literature regarding AOCs. Laparoscopy in experienced hands is safe and effective for the treatment of AONs. Despite the rarity of AOC, a case series should be performed to confirm the results of our case report.