«Un raro caso di linfoma della trachea con stenosi severa»

Primary malignant lymphoma of the trachea is rare and its underlying mechanism remains unknown. Primary tracheal tumors are also very rare causes of airway obstructions. This case report features a 60 year-old woman who presented with the complaint of dyspnea. A mass narrowing the tracheal lumen posteriorly in the subglottic area and mediastinal lymphadenopathy was detected by computed tomography scan and a rijit bronchoscopy was performed. This showed polypoid, variable-sized, irregular nodules causing narrowing of the tracheal lumen over a 3 cm segment in the middle part of the trachea and a mass protruding into the tracheal lumen from the posterior part of the proximal trachea. Multiple biopsy was carried out from the nodules and the airway obstruction was treated with Argon Plasma Coagulation (APC). After removal of the debris, tracheal lumen patency was obtained. The histopathology examination revealed a small lymphocytic primary non-Hodgkin’s lymphoma of the trachea. To our knowledge, this is the first case of small lymphocytic primary tracheal lymphoma in the literature. © Mattioli 1885

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease