Background Esophageal duplication cysts are a rare congenital cystic malformation from faulty intrauterine recanalization of the esophagus during the 4-8 th weeks of development. They account for 20% of all gastrointestinal duplication cysts and commonly involve the distal esophagus. Presenting symptoms may be related to size and location. Materials and Methods Following the PRISMA guidelines, a systematic review was performed by searching published literature in various databases. Data from 97 reported case reports were pooled to present a descriptive and statistical analysis. Results Patient population was composed of 51(52.5%) males and 46 (47.5%) females, and mean ages was 42.3 years (18-77). Distal cysts were the most prevalent. Seventy-nine (81.4%) patients were symptomatic; common symptoms included dysphagia, chest pain, cough and weight loss. Fifteen (15.5%) patients were treated conservatively and 75 (84.5%) by surgical treatment, among them thoracotomy in 30 (30.9%) patients and VATS in 17 (17.5%) patients. Mean length of hospital stay was 8.6 days (range: 1-26 days). One fatality was registered. Location, unlike size, was not found to influence presenting symptoms or treatment employed. Frequency of conservative treatment was not significantly different between symptomatic and asymptomatic patients. Open approaches were associated with longer stays than their minimally invasive counterparts. Conclusion Esophageal duplication cysts remain rare in adults and are frequently located in the distal esophagus. Larger cysts are more likely to cause symptoms. Various surgical techniques may successfully be employed in the treatment of this pathology. Minimally invasive procedures have a shorter hospital stay.

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Introduction and aims A case series of ten patients that received protocolized care for SARS-CoV-2 infection and developed severe gastrointestinal complications, is presented. The aim of our study was to contribute to the ongoing discussion regarding gastrointestinal complications related to SARS-CoV-2 infection. After reviewing the current literature, ours appears to be the first detailed case series on the topic. Materials and methods A retrospective filtered search of all patients admitted to our hospital for SARS-CoV-2 infection, who developed severe gastrointestinal complications, was performed. All relevant data on hospital patient management, before and after surgery, were collected from the medical records. Results Of the 905 patients admitted to our hospital due to SARS-CoV-2 infection, as of August 26, 2020, ten of them developed severe gastrointestinal complications. Seven of those patients were men. There were four cases of perforation of the proximal jejunum, three cases of perforations of the ascending colon, one case of concomitant perforation of the sigmoid colon and terminal ileum, one case of massive intestinal necrosis, and one preoperative death. Three right colectomies, four intestinal resections, one Hartmann’s procedure with bowel resection, and one primary repair of the small bowel were performed. The mortality rate of the patients analyzed was 50%. Conclusion Spontaneous bowel perforations and acute mesenteric ischemia are emerging as severe, life-threatening complications in hospitalized SARS-CoV-2 patients. More evidence is needed to identify risk factors, establish preventive measures, and analyze possible adverse effects of the current treatment protocols.

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Introduction: Multiple studies have reported that breast reconstruction (BR) after mastectomy is paramount in the global treatment of breast cancer (BC). Despite this, BR rates in Mexico are very low (7-16%), which may be explained by the fact that BR is not completely covered by public institutions in our country. Even though BR rates can increase when pertinent information is offered to patients, little is known about the level of information among Mexican patients. We sought to assess the level of information that patients who underwent mastectomy had about BR in a Mexican referral BC center with public healthcare insurance where BR services are not covered, as well as its relationship with their decision-making and the main reasons why they would or would not want to have BR. Methods: A written questionnaire was applied to 110 women who underwent mastectomy to assess their knowledge and desire for BR, and the reasons for or against it. We then analyzed the differences in information perception between women who did or did not desire BR. Results: Mean age was 51 years (30-78). Most patients had lower education (61%), 29% had a monthly income <300 USD, 73% were responsible for their household income, and 57% had ≥3 children. Most patients had tumors >5 cm (66%), with a high proportion of locally advanced clinical stages (67%). Mean times since diagnosis and since mastectomy were 2.2 and 1.9 years, respectively. Two-thirds of patients wished to have BR. Only 28% looked for information about BR; 65% did not recall ever receiving any information about BR from their doctors; 76% said they were not advised by their providers to undergo BR; 83% never asked their doctors for information regarding BR; and 84% believed they did not have enough information about BR. Notably, 12% of patients received their families’ advice not to have a BR. Seven domains were significantly associated with the desire of having a BR. More patients who did not desire a BR than those who did, reported they did not receive or look for information, advice or counseling about their BR options (see table). The five main reasons to have BR were: 1) It would give me freedom to dress in any kind of clothes; 2) To make my breasts look symmetrical; 3) To look like I used to before the mastectomy); 4) To feel more confident; and 5) To feel more attractive. The five main reasons not to have BR were: 1) I am worried about its cost; 2) I do not know the BR options; 3) I do not have enough information about BR; 4) I am worried the cancer could return; and 5) I am afraid that BR complications can happen. Conclusion: This is the first study to evaluate the association between the information, advise and counseling patients receive about BR and their desire to undergo the procedure in an underserved setting such as the Mexican public healthcare system. The amount of information and counseling about BR significantly correlates with women's interest in this procedure. This lack of information about BR from providers might be mainly due to the lack of BR coverage in public services, which likely play a strong role on the low rates of BR in this country. For this reason, it is of utmost importance to ensure that a specific governmental or civil budget is directed to cover this procedure and, ultimately promote the delivery of BR-related information to all BC patients in a standardized manner. Table. Differences in BR interest according to BR knowledgeQuestionsWould you like to have a breast reconstruction? n(%)No (n=37)Yes (n=73)Total (n=110)PNone of my doctors informed me about breast reconstruction30 (81)41 (56)71 (65)0.01None of my doctors advised me to have a breast reconstruction33 (89)51 (70)84 (76)0.024I never asked my doctor for information about breast reconstruction36 (97)55 (70)91 (83)0.004My doctor did not explain there are many types of reconstruction35 (95)51 (70)85 (77)0.003I do not think I have enough information about breat reconstruction35 (95)57 (78)92 (84)0.027I have never approached an NGO or civil society organizations to get a breast reconstruction37 (100)65 (89)102 (93)0.037I have never discussed with my partner about having a breast reconstruction30 (81)36 (49)66 (60)0.001 Citation Format: Paulina Bajonero-Canonico, Melina Miaja-Avila, José Moral de la Rubia, Jorge A Saldaña-Rodríguez, David E Hinojosa-González, Cristel G De la O-Maldonado, Cynthia M Villarreal-Garza. Information gaps and perceived barriers to achieve breast reconstruction among patients with mastectomy in a public breast cancer center in Mexico [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-11-15.