Impact of COVID-19 on the surgical volume of general surgery residents as main surgeons in a National Training Program in Costa Rica: A cross-sectional study.

ABSTRACT: To quantify the impact of coronavirus disease 19 (COVID-19) on the surgical volume of residents' medical practice in Costa Rica's General Surgery Residency Program.The COVID-19 pandemic has caused a significant disruption in people's lives. Health systems worldwide have been forced to adapt to the new normal, which has posed a challenge for medical residency programs, especially in the surgical field.This transversal study includes the surgical records of all residents of the General Surgery program who worked as main surgeons at the Mexico Hospital of the Costa Rican Social Security between December 23, 2019, and June 25, 2020.As main surgeons, a total of 10 residents performed 291 pre-pandemic surgeries and 241 pandemic surgeries.When comparing the distribution of procedures performed by residency levels, it is observed that the postgraduate year -2 increased the number of procedures performed during the pandemic period (pre-pandemic 19% vs pandemic 27%, P = .028). There was no statistically significant difference between the pre-pandemic and pandemic periods in the remaining levels.When comparing the procedures by unit, a statistically significant decrease was observed in the Endocrine-Abdominal Wall Unit (pre-pandemic 18.3% vs pandemic 5.4%, P < .001). Conversely, a statistically significant increase was identified in Surgical Emergencies Unit procedures (40.0% vs post 51.7%, P = .007). No statistically significant differences were observed in the remaining the Units.The COVID-19 pandemic had no statistically significant effect on surgeries performed by residents of the General Surgery Residency Program as main surgeons in a national training center in Costa Rica. The Department's timely measures and pro-resident attitude were the key reasons for the above results.

Insuficienca vascular mesentérica / Insufficiency vascular mesenteric

Justificación y objetivos: La isquemia mesentérica aguda es una de las emergencias gastrointestinales más graves y de peor pronóstico que el cirujano debe afrontar. En Estados Unidos la enfermedad isquémica intestinal se presenta en uno de cada mil ingresos hospitalarios, con una mortalidad entre 60 por ciento y 90 por ciento. Dada la importancia del problema se intenta hacer una descripción de la presentación clínica, diagnóstico, tratamiento y evolución de la patología isquémica intestinal en el factor predisponente más frecuente. En el 66 por ciento de los casos, el diagnóstico se estableció antes de las 12 horas del ingreso mediante laparotomía exploratoria, la tasa de mortalidad en general alcanzó el 81 por ciento. Se encontró una clara subutilización de adecuados estudios imagenológicos para llegar al diagnóstico, siendo la laparotomía una forma tardía de identificación, para realizar un tratamiento oportuno.