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Approximately 28, 404, 603 surgical events have been suspended in the 12 peak weeks of the COVID-19 pandemic. The aim of this study was to report all the surgically intervened patients with suspected or confirmed SARS CoV-2 infection from April 1 to July 31, 2020, and to estimate their prognosis in the Surgical Therapy Department of a third level hospital in Mexico. Method We conducted an observational study of patients undergoing surgical intervention in the operating room assigned as COVID, where we considered age, sex, treating department, type of intervention, and initial biomarkers (first five days of hospitalization), days of hospital stay, days in the Intensive Care Unit and reason for discharge. Results 42 patients have been surgically intervened, with a total of 49 surgeries. For Otolaringology and General Surgery, there were more deceased cases than alive cases; while for Thoracic Surgery, and Obstetrics and Gynecology, there were more alive cases than deceased ones (36% and 0% deceased, respectively), with statistically significant differences (p = 0.014). With regard to mortality for each group of surgical procedure, patients who underwent C-section or pleurostomy had a mortality rate of 0%; the mortality rate for patients who underwent tracheostomy was 52%; patients who underwent laparotomy had a mortality rate of 54%; for those who underwent debridement, the mortality rate was 100%; which show significant differences, with a p value of 0.03. Discussion we identified an overall mortality rate of 42.8%, with a significant difference between treating departments and type of surgical procedure. This can be explained because many of the General Surgery patients, in addition to their infectious process by COVID-19, had another complication, like sepsis, In the same way, we can say that pregnant patients are healthy and have a physiological condition. Finally, patients undergoing an open tracheostomy had solely pulmonary complications. Conclusion There is no doubt that we face an unknown condition for which we have been learning tests along the way. This sample of cases undergoing surgery at the beginning of the COVID-19 pandemic can provide clues on relevant results that we must consider for future cases., Highlights • There is a relation between patients undergoing emergency surgery with SARS-Cov-2 infection and higher mortality rate. • The SARS CoV2 Infection had an important impact in the surgical productivity with a decrease of 85%. • The overall mortality rate for patients with SARS CoV2 infection that were intervened for emergency surgery was 42.8%. • There is a significant difference between treating departments and type of surgical procedure with the mortality rate.

Background: Mediastinitis is a potentially fatal condition. In addition to timely diagnosis, its prognosis depends on an early and systematic approach. Objective: To describe the results of mediastinitis treatment over a period of 34 years in a teaching hospital, its evolution and the current model of care. Materials and methods: Cross-sectional, retrospective and descriptive study of patients with mediastinitis admitted from 1 June 1982 to 30 July 2016. The analysed variables were demographic, classification and aetiology of mediastinitis, comorbidities, complications, length of hospital and intensive care unit stay and mortality. Results: 1880 patients were included of which 1496 (79.6%) were men. The mean age was 39.4 ± 17.8 years. According to the classification of Endo, 603 (32.1%) corresponded to type I and 1277 (67.9%) to types IIA and IIB. According to the aetiology, in 910 cases the origin was odontogenic (48.4%), 526 due to retropharyngeal abscess (28%), 147 secondary to submandibular abscess (7.8%), 49 due to cervical lymphadenectomy (2.6%), 36 due to pharyngeal trauma (1.9%), 14 due to post-intubation tracheal rupture (0.7%) and 198 were of undetermined origin (10.6%). Mediastinotomy with right thoracotomy was performed in 86% and mediastinotomy with left thoracotomy was performed in 14%. Simultaneous tracheostomy was performed in 83% of cases, standardising this procedure since 2005. Mortality varied between periods and was 50% in 1982â1992, 41% in 1992â2001, 35% in 2002â2011 and 17% in 2012â2016. Conclusion: Along with the standardisation of the management of mediastinitis, a fall in mortality from this cause has been observed over the years. The maturity of the proposed model of care is a result of, among other things, medical and scientific advances and the experience gained in this pathology over more than three decades. Resumen: Antecedente: La mediastinitis es un padecimiento potencialmente fatal. Además del diagnóstico oportuno el pronóstico dependerá de un abordaje sistemático temprano. Objetivo: Describir los resultados del tratamiento de la mediastinitis en un periodo de 34 años en un hospital escuela, su evolución y el modelo de atención vigente. Material y métodos: Estudio retrospectivo, descriptivo y transversal de pacientes con mediastinitis ingresados del 1 de junio de 1982 al 30 de julio de 2016. Las variables que se analizan son demográficas, clasificación y etiología de la mediastinitis, comorbilidades, complicaciones, días de estancia en hospital y en terapia intensiva y mortalidad. Resultados: Se incluye a 1880 pacientes de los cuales 1496 (79.6%) fueron hombres. La edad promedio fue de 39.4 ± 17.8 años. Según la clasificación de Endo, 603 (32.1%) correspondieron al tipo I y 1277 (67.9%) a los tipos IIA y IIB. Según la etiología, en 910 casos fue de origen ondotogénico (48.4%), 526 por absceso retrofaríngeo (28%), 147 secundarios a absceso submandibular (7.8%), 49 a linfadenectomía cervical (2.6%), 36 a trauma faríngeo (1.9%), 14 a ruptura traqueal postintubación (0.7%) y 198 de origen indeterminado (10.6%). Se realizó mediastinotomía con toracotomía derecha en 86% y con toracotomia izquierda en 14%. La traqueostomía simultánea se realizó en el 83% de los casos, estandarizándose desde el año 2005. La mortalidad varió por periodos siendo de 50% en 1982 a 1992, de 41% en 1992 a 2001, de 35% en 2002 a 2011 y de 17% en 2012 a 2016. Conclusión: A la par de una estandarización en el manejo de la mediastinitis, se observa un descenso en la mortalidad por esta causa con el pasar de los años. La madurez del modelo de atención que se propone responde entre otros a avances médico-científicos y a la experiencia acumulada en esta patología en más de tres décadas. Keywords: Mediastinitis, Thoracic surgery, Emergency surgery, Neck abscess, Palabras clave: Mediastinitis, Cirugía de tórax, Cirugía de urgencia, Absceso de cuello

Lung cancer is the leading cause of cancer death in both sexes, accounting for nearly a third of all cancer deaths. It causes more deaths than breast, colon, prostate and pancreatic cancer combined. Their overall 5-year survival rate is 15%, however, if caught in early stages it can reach up to 60–70%. Unfortunately, over 70% of lung cancers occur in advanced stages. For early clinical stages of non-small cell tumours, surgical treatment is usually recommended. Recently, the video-assisted thoracic surgery approach has proven to be at least equivalent to open surgery regarding oncologic principles, also showing the advantages of a minimally invasive procedure. In this occasion we present the case of a patient with lung cancer IIB on whom a lobectomy was performed using a minimally invasive approach. The patient was discharged three days after surgery.