RESUMEN
Introduction: The COVID-19 pandemic had an undeniable impact on the health system worldwide, this lead to a delay in the diagnosis and treatment of digestive cancers.The purpose of our study was to assess this delay and its impact on patient care. Method: Our work is a retrospective study about 165 patients that were admitted for digestive cancers at Sheik Khalifa hospital, Casablanca morocco during a 3-year period, that we divided into three. We included all the digestive adenocarcinomas (esophagus excluded) whether they were operated on or not. We excluded all other types of cancers (GIST, serous tumors ). We assessed the time between the beginning of the symptoms and the beginning of the treatment and the number of patients that were diagnosed at the complication stage. We also assessed the staging of the tumor at the moment of diagnosis and the complete surgical resection rate. Results: Among the 165 patients admitted for digestive cancer, 54,9% were males with a sex ratio of 1,22 M/F. The average age of our patients was 62,8 years varying between 25 and 86 years old and with a standard deviation of 11,8 years. Digestive cancers were diagnosed in 79 patients during period 1, 43 patients during period2, and 43 during period 3. We found a statistically significant increase in the percentage of patients with advanced cancer by 21,7% (p = 0,045) from 2019 to 2020. The delay in diagnosis (p = 0,275), percentage of cancer discovered at the stage of complication(p = 0,728), and the reduction in complete surgical resection (p = 0,177) were not statistically significant. Conclusion: Our results show an undeniable impact of the COVID-19 pandemic on the staging of digestive cancers but the impact on their care remains to be proven and needs a long-term survival follow-up.
RESUMEN
Paraesophageal hernias (PEH) have a high recurrence rate, which can justify the use of a mesh during their repair. Mesh use in PEH repair is highly debated as it can lead to many complications like erosion and migration of the mesh, like in our case. Here, we present a case of a 23-year-old woman operated on multiple occasions for a recurring PEH and who presented an intraesophageal migration of the mesh. Partial upper gastrectomy and lower esophagectomy were performed to remove the mesh and the recurrent hernia was repaired using primary sutures of the hiatus. The surgery was without complications and there are no signs of recurrence up to a year later. Reoperation on a recurring PEH can be more difficult in case of mesh use in previous intervention and can lead to other complications like mesh erosion or migration, even so, some surgeons choose this option because it has a lower recurrence rate.
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Pancreas is an uncommon site of hydatid cysts (HCs) even in endemic countries. Primary pancreatic hydatid cysts (PHCs) mainly occur through hematogenous dissemination. Their rarity and the absence of clinical manifestations in most cases explain their challenging preoperative diagnosis. In symptomatic cases, clinical findings may be similar to those of other diseases. We report a case of a 54-year-old female presented with a six-month history of abdominal pain, although her abdominal examination was normal. Radiological imaging revealed a serous cyst in the body and tail of the pancreas. Biliopancreatic endoscopic ultrasound (EUS) suggested a peritoneal hydatid cyst. Intraoperatively, it was diagnosed as a PHC. The patient underwent resection of the PHC and was then placed on albendazole. She did not have any symptoms for the last seven months. Through this case report, we can conclude that peritoneal hydatid cyst of the pancreas should be considered in the differential diagnosis of the cystic lesions of the pancreas. Moreover, surgery achieves a definitive treatment of the disease.
RESUMEN
Coelio-surgery is the gold standard treatment for symptomatic gallbladder lithiasis. Until now, only 42 cases of laparoscopic cholecystectomy in patients with situs inversus have been published. We here report a new case of a patient followed up for complex congenital single ventricle heart disease with situs inversus and dextrocardia. The patient was admitted for the surgical treatment of symptomatic gallbladder lithiasis. Laparoscopic cholecystectomy was performed. Disposal of trocars and surgical approach were completely inverted and symmetric compared to standard laparoscopy.
