Purpose The COVID-19 pandemic caused a lockdown in many countries, which induced negative dietary habits and sedentary behavior. Studies suggest that weight loss of patients undergoing bariatric surgery was equally affected. The aim was to evaluate the impact of COVID-19 on weight loss, obesity-related comorbidities, and nutritional status at 1-year follow-up after gastric bypass (GB). Methods Retrospective observational case–control study of patients undergoing primary GB in a tertiary referral Belgian center. COVID-19 period group was composed by those whose 1-year postoperative period was affected by the COVID-19 pandemic and lockdown: from October 1, 2019, to March 31, 2020. The control group was composed of patients operated from October 1, 2018, to March 31, 2019. Electronic clinical records were reviewed searching: baseline characteristics, weight and comorbidities evolution, and biochemical values. Results A total of 47 patients in the COVID-19 period group and 66 in the non-COVID-19 period group were analyzed. There were no significant differences in baseline characteristics. A reduced weight loss was observed at 1-year follow-up, in terms of percentage of excess weight loss (%EWL) (82.4% [SD: 21.6] vs. 82.4% [SD: 21.6]; p : 0.043) and body mass index (BMI) (27.8 kg/m 2 [IQR: 25.8–30.0] vs. 26.2 kg/m 2 [IQR: 24.6–28.6]; p : 0.029) for COVID-19 period group vs. non-COVID-19 period group, respectively. There was a similar reduction of obesity-related comorbidities, without clinically significant differences in the nutritional follow-up. Conclusion The COVID-19 pandemic and lockdown had an impact on weight loss at 1-year follow-up after gastric bypass. Graphical abstract
The gastro-intestinal stromal tumours (GISTs) are rare mesenchymal tumours that occur mostly in the stomach. The treatment is usually a limited resection, which is performed by an endoscopy or by a surgical approach. In case of metastasis of the disease proven found during the assessment, the treatment is usually limited to chemotherapy without a radical cure. We report a case of a large (9 cm) subcardial GIST that we treated by laparoscopic subtotal gastrectomy due to the size and the location of the tumour. The laparoscopic resection is shown to be superior in perioperative outcomes compared to open surgery even for large lesions. In unfavourable locations such as in cardia lesions, transgastric, partial or extended gastric resections must be evaluated to avoid functional sequelae and post-operative morbidity.
Paragangliomas are rare tumors representing a therapeutic challenge. We present a case report of surgical resection of carotid body tumor without preoperative embolization. Our therapeutic attitude is based on controversial benefits of the embolization for those tumors. The major indication for the preoperative embolization is to reduce intraoperative blood loss, but this benefit is not demonstrated. Also, because the relative rarity of this tumor, the confounding factors relative to the surgeon and radiologist experience, no randomized trial can be performed. So, our case report can be useful to participate to increase the number of reported cases, and define the therapeutic approach for this rare tumor.
Background Odontogenic inflammatory maxillary cysts constitute pathology for which clinical, radiological and evolutionary aspects are considerably polymorphic. For small cystic lesions non-surgical endodontic treatment is used. Larger lesions, however, have a natural tendency to grow and weaken the bone (as well as an inflammatory risk) may be treated by surgery. Case presentation We present a case report of surgical resection of a large maxillary cyst on a patient who previously had multiple dental extractions until complete edentation. Conclusion Great cystic maxillary lesions are relatively rare. A definitive diagnosis cannot be determined based on the history, clinical and radiographic evaluation. A correct pre-operative diagnosis is very difficult and can only be possible after histological examination. Keywords: Dental-radicular cyst, Radiolucency, Maxilla, Enucleation
BackgroundThe bacteriological sample in the presence of intraabdominal free fluid is necessary to adapt the antibiotherapy and to prevent the development of resistance. The aim of this study was to evaluate the differences between uncomplicated (UAA) and complicated acute appendicitis (CAA) in terms of bacterial culture results and antibiotic resistance, and to evaluate the predictors for complicated appendicitis.Material and methodsWe performed a single-centre, retrospective observational study of all consecutive patients who presented with appendicular peritonitis and underwent emergent surgery in a tertiary referral hospital in Brussels, Belgium, between January 2013 and December 2020. 268 patients were analysed in term of medical history, parameters at admission, bacterial culture, antibiotic resistance and postoperative outcomes.ResultsThe positive microbiological culture rate was significantly higher in CAA group (68.2 % vs. 53.4 %). The most frequently isolated bacteria in UAA and CAA cultures were E. coli (37.9 % and 48.6 %), bacteria from the Streptoccocus anginosus group (9.3 % and 7.8 %), and Bacteroides spp. (5 % and 13.1 %). The most commonly observed resistances were against ampicillin (28.9 % and 21.7 %) and amoxicillin/clavulanic acid (16.4 % and 10.5 %) in UAA and CAA, respectively. The predictors for complicated appendicitis were preoperative or intraoperative variables. Neither the culture results, the group of bacterial isolation nor the specific isolated bacteria predicted a complicated appendicitis.Conclusion CAA presented a higher rate of positive cultures with increased identification of Gram negative bacteria. There were not relevant differences in terms of antibiotic resistance.
BackgroundThe bacteriological sample in the presence of intraabdominal free fluid is necessary to adapt the antibiotherapy and to prevent the development of resistance. The aim of this study was to evaluate the differences between uncomplicated (UAA) and complicated acute appendicitis (CAA) in terms of bacterial culture results and antibiotic resistance, and to evaluate the predictors for complicated appendicitis.Material and methodsWe performed a single-centre, retrospective observational study of all consecutive patients who presented with appendicular peritonitis and underwent emergent surgery in a tertiary referral hospital in Brussels, Belgium, between January 2013 and December 2020. 268 patients were analysed in term of medical history, parameters at admission, bacterial culture, antibiotic resistance and postoperative outcomes.ResultsThe positive microbiological culture rate was significantly higher in CAA group (68.2 % vs. 53.4 %). The most frequently isolated bacteria in UAA and CAA cultures were E. coli (37.9 % and 48.6 %), bacteria from the Streptoccocus anginosus group (9.3 % and 7.8 %), and Bacteroides spp. (5 % and 13.1 %). The most commonly observed resistances were against ampicillin (28.9 % and 21.7 %) and amoxicillin/clavulanic acid (16.4 % and 10.5 %) in UAA and CAA, respectively. The predictors for complicated appendicitis were preoperative or intraoperative variables. Neither the culture results, the group of bacterial isolation nor the specific isolated bacteria predicted a complicated appendicitis.Conclusion CAA presented a higher rate of positive cultures with increased identification of Gram negative bacteria. There were not relevant differences in terms of antibiotic resistance.
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