The 3-point internal fixation improved the postoperative clinical outcome of fracture fragment stability compared to two-point fixation, but the mean malar height projection, vertical dystopia, and enophthalmos were not different between the two fixation methods

Three-point internal fixation can improve the clinical outcome of fracture fragment stability compared to 2-point fixation; however, it has a mean operative duration 22.2 minutes longer than 2-point fixation, so its application must be considered during the COVID-19 pandemic.

Three-point internal fixation can improve the clinical outcome of fracture fragment stability compared to 2-point fixation; however, it has a mean operative duration 22.2 minutes longer than 2-point fixation, so its application must be considered during the COVID-19 pandemic.

and importance Synovial sarcoma is a type of spindle cell tumors with unknown cellular origin. It can present anywhere throughout the body; however, its onset in the maxillary sinus is an extremely rare condition, making it hard to diagnose. This tumor occurs equally, without predilection for males or females, and the incidence peaks in the age of 35. The diagnosis is confirmed by histopathological study, and the main treatment is complete surgical excision.

We are reporting a case of a 53-year-old male with a left sided hearing loss accompanied by a left sided nasal block and a vague facial and dental pain.

Magnetic Resonance Imaging (MRI) showed a heterogeneously enhancing tumor in the maxillary sinus that extended to the pterygopalatine fossa and other surrounding structures, and a biopsy showed the tumor to be a synovial sarcoma. The tumor was managed with a less aggressive curative surgery, and was put on an adjuvant radiotherapy, and is being followed regularly; with no recurrence 5 months after therapy.

In conclusion, we are writing this report to introduce a case of synovial sarcoma in a rare location that was managed by a “cosmetically oriented” curative surgery, satisfactory results and prognosis.

In conclusion, we are writing this report to introduce a case of synovial sarcoma in a rare location that was managed by a “cosmetically oriented” curative surgery, satisfactory results and prognosis.

Roux-en-Y gastric bypass (RYGB) is a surgery with low rate complications. However, it is not exempt from them, and 1-6% suffer complications such as postoperative bleeding. Many intraoperative techniques have been evaluated to reduce postoperative bleeding, like the oversewing or reinforcement of the staple line. This study aims to evaluate the rate of postoperative bleeding in the oversewing of the staple line of the gastric remnant group versus the stapling only group.

This is a 2-center, case-control study. We randomly selected two groups who underwent RYGB or OAGB group A (n=225) with oversewing from 2019 to 2020 and group B (n=225) with stapling only between the period of 2017-2018; both groups with similar demographic characteristics.

The overall mean age was 37.39±9.6 years and mean BMI was 41.59±8.6kg/m2; the postoperative bleeding rate was significantly lower (p<0,05) in patients with oversewing of the staple line of the gastric remnant. Operative time was shorter for the stapling only group and the difference between the mean operative time was 10.6min.

Oversewing the staple line of the gastric remnant significantly reduces the incidence of postoperative bleeding regardless of BMI. Being a cost-effective technique compared to others available despite the increase in operating time.

Oversewing the staple line of the gastric remnant significantly reduces the incidence of postoperative bleeding regardless of BMI. read more Being a cost-effective technique compared to others available despite the increase in operating time.

The benefits of using a fibrin sealant to reinforce the pancreaticojejunal anastomosis are still contentious, a fact that justifies the study of its effects on clinical outcomes and costs of pancreaticoduodenectomy.

Study of 62 consecutive patients submitted to pancreaticoduodenectomy, divided into two groups of 31 patients each GWS=group with sealant and GWOS=group without sealant that were compared according to demographic, clinical, laboratory aspects, the incidence of postoperative pancreatic fistula (POPF), according to the definition of the International Study Group on Pancreatic Fistula, updated in 2016, and its postoperative complications categorized according to the Clavien classification, as well as hospital costs evaluated by the absorption costing method (with the exception of those related to medications).

The groups were homogeneous and there were no significant differences in the postoperative clinical course or in the indicators of hospital care between them. Hard texture of pancreatic tissue was the only protective factor against the development of POPF (RR=0.29 (95%CI0,12-0,68); p=0.005). Moreover, hospital costs were higher in GWS than in GWOS (p<0.0001).

The use of fibrin sealant to reinforce pancreaticojejunal anastomosis did not improve the clinical and healthcare outcomes and, in addition, increased hospital costs.

The use of fibrin sealant to reinforce pancreaticojejunal anastomosis did not improve the clinical and healthcare outcomes and, in addition, increased hospital costs.

Surgical complications are common, and their management is an integral part of surgical care. The impact on the surgeon, the “second victim” is significant, particularly in terms of psychological health. The aim of this review is to describe the nature of psychosocial consequences of surgical complications on the surgeons involved.

Following scoping review protocols, we set out to identify the evidence-base for psychosocial consequences on the operating surgeon, predominantly general surgeons, following surgical complications.

This scoping review identified 19 articles, mainly survey and interview based (n=8), with all but one article from first world countries. Seven articles reported on negative emotions or depressive behavioural responses. All original studies reported on difficulty in coping (37.5%), and a range of behaviours. There was little evidence for support structures or active interventions to aid the surgeon post complication.

The review suggests that the psychosocial impact, following a complication, is variable but affects every surgeon irrespective of the level of impact on the patient.