La apendicectomía laparoscópica de incisión única con puerto de guante quirúrgico es rentable y fiable en la apendicitis aguda complicada: Un estudio multicéntrico de casos y controles en Colombia

Antecedentes: El abordaje laparoscópico de puerto único (SPL) y multipuerto (MPL) son el patrón oro del tratamiento de la apendicitis aguda, debido a sus múltiples ventajas sobre la cirugía abierta, principalmente por sus efectos directos sobre la recuperación, la estética y los costes del procedimiento. Sin embargo, en los países del tercer mundo, el abordaje laparoscópico aún no es totalmente reproducible debido a los costes de la técnica. La apendicectomía laparoscópica de incisión única con puerto de guante quirúrgico (SGP-SILA) se ha propuesto como una opción viable. Sin embargo, nunca ha sido estudiada en Colombia. Objetivo: Evaluar el costo-efectividad y la confiabilidad de la SGP-SILA en el manejo de la apendicitis aguda complicada, comparada con el abordaje tradicional MPL. Materiales y métodos: Se realizó un estudio retrospectivo de casos y controles comparando pacientes sometidos a apendicectomía laparoscópica por SGP-SILA vs. MPL, evaluando costos operatorios asociados a variables intraoperatorias y postoperatorias en dos centros terciarios de Bogotá, Colombia. Los datos fueron analizados y expresados según su naturaleza y distribución. Resultados: Se incluyeron 116 pacientes (SGP-SILA: 62 y MPL: 54). La mediana del tiempo quirúrgico para SGP-SILA fue de 60 min frente a 39 min para MPL. Se demostró que la SGP-SILA causaba una menor frecuencia de infección del sitio quirúrgico (4 frente a 8 pacientes; p = 0,047). Se encontró una correlación significativa entre la infección del sitio quirúrgico de grado III y el tiempo de cirugía (p = 0,047) en el grupo MPL; también, con la estancia hospitalaria (p < 0,001). Asimismo, se encontró un menor riesgo de infección del sitio quirúrgico con la técnica SGP-SILA (22% frente a 31%). La SGP-SILA generó una reducción de los costes operativos directos e indirectos de aproximadamente el 10% (616 USD frente a 683 USD). Conclusiones: La SGP-SILA y la MPL son procedimientos factibles y comparables en la resolución de la apendicitis aguda complicada. La SGP-SILA resulta ser más rentable que la MPL, debido al uso de instrumentos más fácilmente accesibles. Puede ser una técnica reproducible en países de ingresos bajos y medios.Background: The single-port (SPL) and multi-port (MPL) laparoscopic approach are the gold standard of management of acute appendicitis, due to its multiple advantages over open surgery, mainly because of its direct effects on recovery, esthetics and costs of the procedure. However, in third-world countries, the laparoscopic approach is not yet fully reproducible due to the costs of the technique. The surgical-glove port single incision laparoscopic appendectomy (SGP-SILA) has been proposed as a viable option. However, it has never been studied in Colombia. Objective: To evaluate the cost-effectiveness and reliability of SGP-SILA in the management of complicated acute appendicitis, compared to traditional MPL approach. Materials and methods: A retrospective case control study was carried out comparing patients undergoing laparoscopic appendectomy by SGP-SILA vs. MPL, evaluating operating costs asso- ciated with intraoperative and postoperative variables in two tertiary centers in Bogota, Colombia. The data were analyzed and expressed according to their nature and distribution. Results: 116 patients were included (SGP-SILA: 62 and MPL: 54). The median surgical time for SGP-SILA was 60 min vs. 39 min for MPL. SGP-SILA was shown to cause lower frequency of surgical site infection (4 vs. 8 patients; p = 0.047). It was found a significant correlation between Grade III surgical site infection and surgery time (p = 0.047) in the MPL group; also, with hospital stay (p < 0.001). Also, a lower risk of surgical site infection was found with the SGP-SILA technique (22% vs. 31%). SGP-SILA generated a reduction in both direct and indirect oper- ating costs of approximately 10% (616 USD vs. 683 USD). Conclusion: SGP-SILA and MPL are feasible and comparable procedures in the resolution of complicated acute appendicitis. SGP-SILA turns out to be more cost-effective compared to MPL, due to the use of more easily accessible instruments. This may be a reproducible technique in low- and middle-income countries

The Silent Threat of Non-native Fish in the Amazon: ANNF Database and Review

Non-native fish (NNF) can threaten megadiverse aquatic ecosystems throughout the planet, but limited information is available for the Amazon Region. In this study we review NNF data in the Amazonian macroregion using spatiotemporal records on the occurrence and the richness of NNF from a collaborative network of 35 regional experts, establishing the Amazon NNF database (ANNF). The NNF species richness was analyzed by river basin and by country, as well as the policies for each geopolitical division for the Amazon. The analysis included six countries (Brazil, Peru, Bolivia, Ecuador, Venezuela, and Colombia), together comprising more than 80% of the Amazon Region. A total of 1314 NNF occurrence records were gathered. The first record of NNF in this region was in 1939 and there has been a marked increase in the last 20 years (2000–2020), during which 75% of the records were observed. The highest number of localities with NNF occurrence records was observed for Colombia, followed by Brazil and Bolivia. The NNF records include 9 orders, 17 families and 41 species. Most of the NNF species are also used in aquaculture (12 species) and in the aquarium trade (12 species). The most frequent NNF detected were Arapaima gigas, Poecilia reticulata and Oreochromis niloticus. The current data highlight that there are few documented cases on NNF in the Amazon, their negative impacts and management strategies adopted. The occurrence of NNF in the Amazon Region represents a threat to native biodiversity that has been increasing “silently” due to the difficulties of large-scale sampling and low number of NNF species reported when compared to other South American regions. The adoption of effective management measures by decision-makers is urgently needed and their enforcement needed to change this alarming trend and help protect the Amazon’s native fish diversity.

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data