Background Spontaneous pneumomediastinum (SP) is the presence of free air into extra-alveolar tissues within the mediastinum, without notion of trauma. This rare condition may occur as a complication of an underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Higher rates of mechanical ventilation are reported in coronavirus disease 2019 (COVID-19) patients with pneumomediastinum. Case Description We report two cases of COVID-19 infected patients suffering from mild and severe SP and their outcome. Discussion The objective of this report is to review the literature about this condition. We discuss about the pathological pathways underlying this complication and how it reflects the severity of COVID-19 pneumonia. Conclusion Currently, it remains unclear if SP in SARS-CoV-2 pneumonia is a potential predictor of disease worsening, for it does not seem to be related with a higher rate of mortality.
Objective: To investigate the way robotic assistance affected rate of complications in bariatric surgery at expert robotic and laparoscopic surgery facilities. Summary background data: While the benefits of robotic assistance were established at the beginning of surgical training, there is limited data on the robot’s influence on experienced bariatric laparoscopic surgeons. Methods: We conducted a retrospective study using the BRO clinical database (2008–2022) collecting data of patients operated on in expert centers. We compared the serious complication rate (defined as a Clavien score ≥3) in patients undergoing metabolic bariatric surgery with or without robotic assistance. We used a Directed Acyclic Graph to identify the variables adjustment set used in a multivariable linear regression, and a propensity score matching to calculate the Average Treatment Effect (ATE) of robotic assistance. Results: The study included 35,043 patients (24,428 SG; 10,452 RYGB; 163 SADI-S), with 938 operated on with robotic assistance (801 SG; 134 RYGB; 3 SADI-S), among 142 centers. Overall, we found no benefit of robotic assistance regarding the risk of complications (ATE= -0.05, P=0.794), with no difference in the RYGB+SADI group (P=0.322) but a negative trend in the SG group (more complications, P=0.060). Length of hospital stay was decreased in the robot group (3.7±11.1 vs. 4.0±9.0 d, P<0.001). Conclusion: Robotic assistance reduced the length of stay but did not statistically significantly reduce postoperative complications (Clavien score ≥3) following either GBP or SG. A tendency toward an elevated risk of complications following SG requires more supporting studies.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.