COVID-19 pandemic: an update on the reaction attitude of the spine societies and their members worldwide

BACKGROUND All surgical specialties have been influenced by the coronavirus disease 2019 (COVID-19) pandemic, and substantial changes have been determined in medical assistance, especially in elective surgery. Several spine societies have published recommendations to provide optimal care during this unique situation. AIM To discuss the recommendations by many spine societies for the management of spinal diseases during the COVID-19 pandemic. METHODS The present study was performed according to the PRISMA guidelines. A review of the MEDLINE database (PubMed – National Library of Medicine), Google, and Google Scholar was performed from March 2020 to date for articles published in the English Language. RESULTS Spine associations and societies worldwide were divided into three groups: Continental, specialty and country-based societies. A total of 27 spine associations were included in this review. There were eight major continental associations, but only one-third of these had published guidelines and recommendations on this topic. On the other hand, the specialty-based societies have not addressed the topic, except in two cases. CONCLUSION The national spine societies showed the deepest concern on this topic with several publications in scientific journals influenced by the local epidemiological severity. Contrarily, continental and specialty-based societies showed less interest in this topic

Gallstones in Elderly Patients: Impact of Laparoscopic Cholecystectomy

The use of laparoscopic cholecystectomy (LC) in elderly patients may pose problems because of their poor general condition, especially of cardiopulmonary function. Moreover, these patients present with acute cholecystitis and associated common bile duct stones more often than their younger counterparts. From 1990 to 1999, the authors performed 943 LCs; 31 (3.2%) were attempted on elderly patients, 11 (35%) of which were on an emergency basis because of acute cholecystitis, cholangitis or acute biliary pancreatitis. Ten per cent of LCs needed to be converted to an open cholecystectomy, most often because of an increase in the partial pressure of carbon dioxide in the blood produced by excessive operative time. A gasless procedure was used in the last three years of the study on eight cases; the overall rate of conversion from LC to open cholecystectomy in this group was 0%. Associated gallbladder and common bile duct stones were found in five (16%) patients (four preoperative LC endoscopic sphincterotomy and one transcystic approach). The success rate in both of these cases was 100%, overall morbidity was 29% and there was no mortality. These results show that LC is a feasible and safe procedure for use in elderly patients. Gasless LC should be preferred in patients classified as American Society of Anesthesiologists' class III because an excessive duration of operation is the most common reason for converting to an open cholecystectomy

Anterior corpectomy and plating with carbon-peek instrumentation for cervical spinal metastases: clinical and radiological outcomes

Background: Anterior cervical corpectomy and plating has been recognized as a valuable approach for the surgical treatment of cervical spinal metastases. This study aimed to report the surgical, clinical and radiological outcomes of anterior carbon-PEEK instrumentations for cervical spinal metastases. Methods: Demographical, clinical, surgical and radiological data were collected from 2017 to 2020. The Neck Disability Index (NDI) questionnaire for neck pain, EORTC QLQ-C30 questionnaire for quality of life, Nurick scale for myelopathy and radiological parameters (segmental Cobb angle and cervical lordosis) were collected before surgery, at 6 weeks postoperatively and follow-up. Results: Seventeen patients met inclusion criteria. Mean age was 60.9 ± 7.6 years and mean follow-up was 12.9 ± 4.0 months. The NDI (55.4 ± 11.7 to 25.1 ± 5.4, p < 0.001) scores and the EORTC QLQ-C30 global health/QoL significantly improved postoperatively and at the last follow-up. The segmental Cobb angle (10.7◦ ± 5.6 to 3.1◦ ± 2.2, p < 0.001) and cervical lordosis (0.9◦ ± 6.7 to −6.2 ± 7.8, p = 0.002) significantly improved postoperatively. Only one minor com-plication (5.9%) was recorded. Conclusions: Carbon/PEEK implants represent a safe alternative to commonly used titanium ones and should be considered in cervical spinal metastases management due to their lower artifacts in postoperative imaging and radiation planning. Further larger comparative and cost-effectiveness studies are needed to confirm these results

Increased safety and diagnostic availability of laparoscopy with a new trocar

Les auteurs décrivent un nouveau trocart, réalisé par Olympus-Winter-IBE selon leurs instructions. Ce trocart présente la caractéristique d'une cannule fendue à son extrémité distale par deux fenêtres latérales opposées, présente Les avantages de ce trocart sont : 1. Une vision directe des tissus pariétaux traversés par le trocart et la possibilité de reconnaître un vaisseau lésé d'en réaliser la compression temporaire en attendant l'hémostase chirurgicale. 2. La vision à travers les fenêtres de la cannule permet d'observer le péritoine pariétal au niveau de la zone habituellement aveugle, de 5 à 10 cm de diamètre située autour du point d'insertion du trocart. Cette vision présente un intérêt particulier dans l'hypertension portale et les lésions inflammatoires localisées. Ce modèle de trocart utilisé pendant une période d'environ 5 ans, n'a entraîné aucune complication et sa manipulation s'est avérée aisée même dans les mains de laparoscopistes débutants

Patologia stomale: esperienza ambulatoriale nella correzione chirurgica

[no abstract available