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Background: The pandemic crisis created conditions of insecurity and threat and brought about changes in social contacts and everyday life. Frontline healthcare workers (HCW) were mostly affected. We aimed to evaluate the quality of life and negative emotions in COVID-19 HCW and searched for factors influencing the above. Methods: The present study was conducted among three different academic hospitals in central Greece (04/2020–03/2021). Demographics, attitude towards COVID-19, quality of life, depression, anxiety, stress (using the WHOQOL-BREF and DASS21 questionnaire) and the fear of COVID-19 were assessed. Factors affecting the reported quality of life were also assessed. Results: The study involved 170 HCW in COVID-19 dedicated departments. Moderate levels of quality of life (62.4%), satisfaction with social relations (42.4%), working environment (55.9%) and mental health (59.4%) were reported. Stress was present in 30.6% of HCW; 20.6% reported fear for COVID-19, depression (10.6%) and anxiety (8.2%). HCW in the tertiary hospital were more satisfied with social relations and working environment and had less anxiety. Personal Protective Equipment (PPE) availability affected the quality of life, satisfaction in the work environment and the presence of anxiety and stress. Feeling safe during work influenced social relations and fear of COVID-19 Conclusion: The HCW quality of life is affected in the pandemic. Feelings of safety during work related to the reported quality of life.

Sleeve gastrectomy (SG) is currently the most commonly performed bariatric procedure worldwide. The aim of the present study was to evaluate the long-term efficacy of SG as a stand-alone bariatric procedure.A single-center retrospective analysis of 104 patients who underwent SG as a stand-alone bariatric procedure between January 2005 and December 2009. Weight loss, weight regain, remission or improvement of comorbidities and the new onset of comorbidities were the main outcomes of the study.The percent excess body weight loss (%EBWL), percent excess body mass weight (BMI) loss (%EBMIL), and percent total body weight loss (%TBWL) were 59 ± 25, 69 ± 29, and 29 ± 12, respectively, after a mean follow-up of 13.4 years. At the last follow-up, nearly two thirds of patients (67.3%) had an %EBWL greater than 50. The percentage of patients who experienced significant weight regain ranged from 47 to 64%, depending on the definition used for weight regain. The rate of improvement or remission of hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, and degenerative joint disease at a mean follow-up of 13.4 years was 40%, 94.7%, 70%, 100%, and 42.9%, respectively. The new onset of gastroesophageal reflux disease (GERD) symptoms in the same period was 43%.Our data supports that SG results in long-lasting weight loss in the majority of patients and acceptable rates of remission or improvement of comorbidities. Weight regain and GERD may be issues of particular concern during long-term follow-up after SG.

Introduction: Sleeve gastrectomy (SG) is currently the most commonly performed bariatric procedure worldwide. The aim of the present study was to evaluate the long-term efficacy of SG as a stand-alone bariatric procedure.Methods: A single center retrospective analysis of 104 patients who underwent SG as a stand-alone bariatric procedure between January 2005 and December 2009. Weight loss, weight regain, remission or improvement of comorbidities, and the new onset of comorbidities were the main outcomes of the study.Results: At a mean follow-up of 13.4 years, % excess body weight loss (%EBWL), % excess BMI loss (%EBMIL) and % total body weight loss (%TBWL) were 59 ± 25, 69 ± 29 and 29 ± 12, respectively. Approximately two third of patients (67.3%) maintained an %EBWL of > 50 at the last follow-up. The percentage of patients who experienced significant weight regain ranged from 47% to 64%, depending on the definition used for weight regain. The rate of improvement or remission of hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea and degenerative joint disease at a mean follow-up of 13.4 years was 40%, 94.7%, 70%, 100% and 42.9%, respectively. The new onset of gastroesophageal reflux disease (GERD) in the same period was 43%.Conclusion: Our data support that SG results in long-lasting weight loss in the majority of patients and acceptable rates of remission or improvement of comorbidities. Weight regain and GERD may be issues of particular concern during long-term follow-up after SG.

Pancreatic and periampullary adenocarcinoma have not generally been included in the tumour types considered for metastasectomy. However, there is an increasing interest that metastasectomy in well-selected patients can prolong survival. This review aims to establish the recent evidence on the surgical management of oligometastatic disease and survival outcome in patients who underwent metastasectomy focusing on isolated hepatic and pulmonary metastases.A systematic search was performed in the PubMed database to identify all original articles on the role of metastasectomy for oligometastasis of pancreatic and periampullary adenocarcinoma. Data on methodologies used, 1,3,5 - year survival and median overall survival were summarized, and used to address relevant clinical questions related to the survival outcome in patients who underwent metastasectomy.Sixteen studies were included in this review. All the studies included were retrospective and heterogenous in nature and did not have a uniform reporting on survival outcomes.There is insufficient evidence to support a change of current practice in managing metastatic pancreatic and periampullary cancer. However, patients with ampullary cancer as the primary and any patients with first recurrence as isolated pulmonary metastases had better prognosis than patients with synchronous metastasis or metastases to the liver. This need to be explored in future studies.

Background. High quality patient specific 3D liver models can be nowadays exported using computer liver segmentation algorithms. Specific 3D image editing tools can be used to manipulate the liver models and create virtual surgical cases. Objective. The aim of our study was to create virtual hepatic surgery scenarios using a novel liver segmentation and preoperative planning application and evaluating it as an educational tool. Method. A liver segmentation and preoperative planning application was developed on MATLAB® 2013a. Special image editing tools were designed to allow manipulation of the exported 3D liver models. Three pathological and two liver imaging datasets from healthy patients were used for the validation. The 3D liver models which have been created after liver segmentation were then manipulated by; 1) changing tumors’ volumes, 2) adding tumors and 3) designing liver injuries. Addition fictitious clinical information were implemented. Residents were asked to study the virtual cases and propose resection plans. Their scenarios were evaluated and discussed with specialized liver surgeons. The Kirkpatrick’s four levels model of learning evaluation was used. Results. Up to 30 different virtual liver surgical cases were created. The number of virtual scenarios that could be designed is theoretically unlimited. The residents quickly and effectively learned to evaluate critical anatomical and pathological structures and propose liver resection plans considering liver surgery principles. Conclusions. Virtual hepatic surgery scenarios allowed for a rapid education without the need to wait for similar real cases. The proposed liver segmentation and hepatectomy simulation application can be used for educational purposes.