ABSTRACT Background: Hospital Eva Perón in the city of Granadero Baigorria was almost exclusively dedicated to the care of COVID-19 patients; thereby, it was necessary to modify its activities, as those of the postgraduate program in General Surgery of Facultad de Ciencias Médicas, Universidad Nacional de Rosario, which take place in this hospital. The aim of this study is to describe the changes made and the performance of the postgraduate program in general surgery at HEEP during the COVID-19 pandemic, and its impact on trainees’ education. Material and methods: We conducted a descriptive study comparing the period between March 20, 2020, and September 30, 2020, with the same period in 2019. The variables analyzed included number of surgeries, hours spent in hospital, number of in-house call shifts, activities in the outpatient clinic and evaluation of patients, theoretical seminars, attendance to classes of the postgraduate programs and research work. Results: The total number of surgeries decreased by 74.88%, scheduled surgeries by 85.59% and emergency surgeries by 63.19%. The numbers of in-house call shifts of PGY-1, PGY-2 and PGY-3 residents decreased but not those of PGY-4 residents. The hours spent in hospital decreased in all the trainees. The number of patients hospitalized decreased by 74.06% and there was a reduction in all the activities of the outpatient clinics. The academic activities, performed non-face-to-face, increased. Conclusion: The COVID-19 pandemic significantly affected trainees’ education in the postgraduate program in General Surgery at HEEP. Non-traditional teaching methods were used for updating and discussing scientific papers.

RESUMEN Antecedentes: El Hospital Eva Perón de la ciudad de Granadero Baigorria se destinó a la atención casi exclusiva de pacientes afectados por COVID-19, lo que implicó modificar las actividades que allí se desarrollan. Allí se realizan actividades correspondientes al Posgrado de Cirugía General de la Facultad de Ciencias Médicas de la Universidad Nacional de Rosario. El objetivo es describir los cambios y el funcionamiento del posgrado de Cirugía General en el HEEP durante la pandemia por COVID-19, y el impacto que esta tuvo sobre la formación de los alumnos. Material y métodos: se realizó un trabajo descriptivo, comparativo. Período 20 de marzo de 2020 al 30 de septiembre de 2020 y el mismo período del año 2019. Variables analizadas: número de cirugías, horas en el hospital, número de guardias, actividad en consultorio y pacientes evaluados, seminarios teóricos, cursado de la carrera de posgrado. Resultados: las cirugías totales se redujeron un 74,88%. Las cirugías programadas se redujeron un 85,59%. Las cirugías de guardia se redujeron un 63,19%. Las guardias de R1, R2 y R3 se vieron disminuidas, al contrario de R4. Las horas en el hospital se redujeron en todos los alumnos. Los pacientes ingresados disminuyeron el 74,06%. La atención en todos los consultorios se vio reducida. Las actividades académicas se incrementaron, de forma no presencial. Conclusión: la pandemia por COVID-19 afectó significativamente la formación de los alumnos del posgrado de Cirugía General del HEEP. Se recurrió a métodos no tradicionales de enseñanza para realizar actualizaciones y discutir trabajos científicos.

Background: the Cholecystoscopic Cholecystosclerosis is a single session procedure, under enhancing process, which pursues a definitive Gallbladder eliminaton by means of stone removal and mucous membrane ablaton through Operatory Cholecystoscopy, under local-regional anesthesia, and requires the inserton of a Cholecistoscopy Cannula from the abdominal wall toward the gallbladder fundus. Objective: to assess the efectiveness of the Preoperative Sonography when it comes to finding the right place for the Cholecystoscopy Cannula inserton. It is important to achieve the Cholecystoscopy Cannula being introduced in a way that its axis matiches the Gallbladder´s axis, in order to provide a suitable passage for instruments between the Cannula and the Gallbladder´s lumen. Material and Method: preoperative sonography was planned to be performed in a series of surgical interventons on pigs, in order to determine the positon of the gallbladder in its three spatal dimen-sions, allowing a virtual projecton of the organ´s axis toward the abdominal wall, thus pointing to the most suitable place for the Cholecystoscopy Cannula inserton. Results: fve procedures were performed as planned, the Cholecystoscopy Cannula rapidly reached the gallbladder fundus and coincidence between cannula axis and gallbladder axis was achieved in all the cases. Conclusions: preoperative sonography seems to be very eficient for choosing the right place for Cholecystoscopy Cannula inserton accordingly to this experience.

Antecedentes: la colecistoesclerosis colecistoscópica es un procedimiento de sesión única en etapa de perfeccionamiento, diseñado para lograr la eliminación definitiva de la vesícula biliar con anestesia locorregional. Comprende la remoción de litos y eliminación de epitelio vesicular vía colecistoscópica, para lo cual requiere la colocación de una cánula de colecistoscopia desde la pared abdominal hasta el fondo vesicular. Objetivo: evaluar si la Ecografia preoperatoria es eficaz para definir el lugar donde debe realizarse el ojal de pared, para que permita a la cánula llegar al fondo vesicular, de manera que el eje de la cánula y el eje de la vesícula coincidan, y que el acceso de instrumental a la luz vesicular sea fuido. Material y métodos: se planificó utlizar Ecografia preoperatoria en una serie de operaciones en cerdos, para definir la posición de la vesícula con respecto a las tres dimensiones del espacio, y prolongar en forma virtual el eje del órgano hacia la pared abdominal e identificar el lugar adecuado para confeccionar el ojal de pared. Resultados: se realizó una serie de 5 operaciones de acuerdo con lo planificado; se logró acceder rápidamente con la cánula de colecistoscopia al fondo vesicular y se constató que el eje de la cánula y el eje de la vesícula coincidieron en todos los casos. Conclusiones: la experiencia ofrece un frme indicio de que la Ecografia preoperatoria es muy eficaz para definir el lugar adecuado en la pared abdominal para colocar la cánula de colecistoscopia.

Os autores avaliaram a concordância diagnóstica cito-histológica de lesões de colo uterino e discutiram as eventuais discrepâncias. OBJETIVO. Averiguar o nível de concordância cito-histológica nos casos da Divisão de Patologia do Instituto Adolfo Lutz (IAL) e aprimorar a estratégia de garantia de qualidade na instituição. MATERIAL E MÉTODO. Estudaram 157 casos consecutivos dos arquivos do IAL em que foram enviadas citologia cérvico-vaginal e biópsia. RESULTADO. Houve concordância absoluta em 119 (75,8%) casos; nos demais, a citologia superestimou 11 lesões (7,0%) e subestimou 27 (17,2%). Observou-se que em 5 casos, inicialmente diagnosticados como inflamatório pela citologia, dois foram, à revisão, considerados como NIC 1; os demais foram ratificados como inflamatórios, apesar de suas respectivas biópsias terem diagnóstico de neoplasia intra-epitelial cervical. CONCLUSÃO. Tais resultados demonstram a importância da correlação cito-histológica para o sistema de garantia de qualidade em diagnóstico citológico e apontam para a colheita como um dos fatores determinantes nas discrepâncias diagnósticas.

The cytohistologic diagnosis concordance of the cervix-uterine lesions was evaluated and the discordances are discussed. PURPOSE. To evalute the level of cytohistological diagnosis agreement in the Pathology Division of the Adolfo Lutz Institute and enhance parameters of quality assurance system developed in this institution. METHODS. The authors retrospectively evaluated 157 pairs of cytologyhistology consecutive cases from the files the Adolfo Lutz Institute (Division of Pathology). RESULTS. Agreement was found in 119 cases (75.8%); in the remaining cases cytologic diagnosis were higher than histology in 11 lesions (7.0%) and lower in 27 (17.2%). We also observed that in 5 cases previously diagnosed as inflammatory, 2 of them were reclassified as CIN 1; after revision, the others remained as inflammatory even though they had a histological diagnosis of CIN. CONCLUSION. These results showed the role of cytohistological correlation to the quality assurance system of cytological diagnosis and also stressed the importance of taking the cervical scrapes with accurate care to avoid diagnostic discrepances.