Extra-peritoneal hysteroannessiectomy with eventual concomitant en bloc rectal resection and cytoreductive surgery in epithelial ovarian cancer (and other peritoneal surface malignancies): technical details

Surgery allows the correct evaluation of the peritoneal dissemination of the epithelial ovarian cancer (EOC) and the removal of as much tumor as possible to maximize adjuvant chemotherapy. Neoadjuvant chemotherapy (NACT) and interval debulking surgery have been proposed as a reasonable alternative to primary complete cytoreductive surgery (CRS) in patients not fit for an initial extensive debulking surgery. Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) has been offered as a promising therapeutic procedure to increase survival by treating the microscopic component of the neoplastic disease. Matherial and Method. 419 eligible patients with stage III-IV EOC were subjected to CRS, previous NACT in 343 patients, 20 of which with CRS combined with extraperitoneal hysterectomy (EH) + HIPEC. Purposes of our four years retrospective observational study are the revision of the surgical approaches to the EOC, a detailed report of the pelvic peritonectomy in association to hysteroannessiectomy (+/- consensual rectal resection) and the prospective review of the results. Conclusions. This study shows that EH + HIPEC is feasible. The detailed description of the technique here depicted could help to standardize this type of peritonectomy

Thyroid Cancer and Nodules in Graves' Disease: A Single Center Experience

The existence of a link between Graves' Disease (GD) and Thyroid Cancer (TC) has long been investigated, however a clear pathogenic correlation has still to be found

Long-Term Mental and Physical Quality of Life after Radical and Conservative Surgeries and in Relation to Childbirth in Patients with Severe Endometriosis

Aim: This study aimed to investigate which surgery (conservative, radical) is the most effective in improving quality of life and if childbirth after conservative one affects outcomes. Method: 79 women who underwent radical or conservative surgery for severe endometriosis were assessed by means of a semistructured interview and completed the SF-36. Results: Our findings showed that in the whole model of Hierarchical multiple linear regression analyses, surgery group explained significantly 10.7% of variance for bodily pain, 7.2% for general health, and 7.9% for vitality, independently of age and months spent since surgery. Groups of childbirth differed significantly for vitality (p .018, Cohen’s d .939) and role emotional (p .034, Cohen’s d .786). Discussion: Findings suggested that women with endometriosis who underwent radical surgery showed better quality of life in long term, independently of age and time spent since treatment. Moreover, women who gave birth to a child had a better mental quality of life, especially concerning vitality and role limitations due to emotional problems

Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers?:An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

Introduction: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery. Patients and Methods: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group. Results: In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19. Conclusions: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19

Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

Introduction: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery. Patients and Methods: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group. Results: In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19. Conclusions: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19