Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Iliofemoral stenting for chronic venous occlusive disease: Initial and mid-term outcomes in single institution

Aim of the work: To evaluate and report the initial and midterm outcomes of endovascular venous stenting in cases suffering from chronic venous insufficiency due to iliac and common femoral vein obstruction. Patients & methods: Patients with chronic venous insufficiency were referred to our institution during the period from January 2014 to October 2015. CT venography was performed to evaluate site and extent of proximal venous stenosis or obstruction. Then conventional venography and endovascular stenting were done. The patency of the stents was assessed at short and midterm follow-up examinations. Results: CT venography revealed proximal iliac vein obstruction in 9 cases and common femoral vein obstruction in 3 cases. All were post-thrombotic. Technical success was 67% (8/12) with no immediate major complications. Follow-up CT venography done 1 month post-procedure revealed no restenosis. After one year 8 patients showed overall improvement of symptoms with decrease in lower limb edema, swelling and pain. Conclusion: Stent implantation for symptomatic ilio-femoral venous obstruction is a safe and effective procedure to resolve venous disease symptoms. Despite the small number of patients, initial and mid-term outcome has been good