ABSTRACT
AIM: The aim of this study is to point out the changes and possible delay in diagnosis or treatment of malignancies and an added risk of COVID-19 exposure emerging from these interventions, as well as to underline the increase of surgical demand once the pandemic measures are eased. METHODS: This study is a retrospective review of the patients operated between 11.03.2020 and 31.05.2020 in a center with a high incidence of COVID-19 infection during the pandemic. The numbers of emergency, elective and oncological surgeries as well as the increasing or decreasing trends of these interventions between March 11 and May 31 of previous years were compared with the corresponding period of 2020 or in other words the pandemic period. RESULTS: From March 11 to May 31, 2020 there was a progressive reduction in surgical activity, with only 195 operations: 61(31,28%) on a scheduled basis for tumor pathology, 59(30,25%) for benign pathology and 75(38,46%) for emergency indications. When the surgical trends of previous years are considered, all types of oncological surgeries decreased significantly in pandemic period March 11 to May 31, 2020. CONCLUSION: One of the most striking changes in medical care settings during the COVID-19 pandemic was observed in surgical management strategies. The most significant among these were the limitation of elective surgical procedures and the prioritization of emergency or non-delayed oncological operations. One may speculate that the standstill of elective surgeries including the oncological surgeries might have long term impacts on the clinical outcomes of patients as well as the healthcare workers and organizations. KEY WORDS: COVID-19, Emergency, Oncology, Pathology, SARS-CoV-2, Surgery. Lo scopo di questo studio è di evidenziare i cambiamenti e il possibile ritardo nella diagnosi o nel trattamento di tumori maligni e un ulteriore rischio di esposizione a COVID-19 che emerge da questi interventi, nonché di sottolineare l’aumento della domanda chirurgica una volta che le misure pandemiche saranno alleviate. Questo studio è una revisione retrospettiva dei pazienti operati tra l’11.03.2020 e il 31.05.2020 in un centro con un’alta incidenza di infezione da COVID-19 durante la pandemia. Il numero di interventi chirurgici di emergenza, elettivi e oncologici, nonché le tendenze crescenti o decrescenti di questi interventi tra l’11 marzo e il 31 maggio degli anni precedenti sono stati confrontati con il corrispondente periodo del 2020 cioè con il periodo di pandemia. Risultati: dall’11 marzo al 31 maggio 2020 si è verificata una progressiva riduzione dell’attività chirurgica, con solo 195 interventi: 61 (31,28%) su base programmata per patologia tumorale, 59 (30,25%) per patologia benigna e 75 (38,46%) per indicazioni di emergenza. Quando si considerano le tendenze chirurgiche degli anni precedenti, tutti i tipi di interventi chirurgici oncologici sono diminuiti significativamente nel periodo di pandemia dall’11 marzo al 31 maggio 2020. Conclusione: uno dei cambiamenti più sorprendenti nelle impostazioni di assistenza medica durante la pandemia di COVID-19 è stato osservato nelle strategie di gestione chirurgica. I più significativi tra questi sono stati la limitazione delle procedure chirurgiche elettive e la definizione delle priorità delle operazioni oncologiche di emergenza o non ritardate. Si potrebbe ipotizzare che l’arresto di interventi chirurgici opzionali, inclusi quelli oncologici, potrebbe avere impatti a lungo termine sugli esiti clinici dei pazienti, nonché degli operatori sanitari e delle organizzazioni.
ABSTRACT
AIM: The aim of this study is to point out the changes and possible delay in diagnosis or treatment of malignancies and an added risk of COVID-19 exposure emerging from these interventions, as well as to underline the increase of surgical demand once the pandemic measures are eased. METHODS: This study is a retrospective review of the patients operated between 11.03.2020 and 31.05.2020 in a center with a high incidence of COVID-19 infection during the pandemic. The numbers of emergency, elective and oncological surgeries as well as the increasing or decreasing trends of these interventions between March 11 and May 31 of previous years were compared with the corresponding period of 2020 or in other words the pandemic period. RESULTS: From March 11 to May 31, 2020 there was a progressive reduction in surgical activity, with only 195 operations: 61(31,28%) on a scheduled basis for tumor pathology, 59(30,25%) for benign pathology and 75(38,46%) for emergency indications. When the surgical trends of previous years are considered, all types of oncological surgeries decreased significantly in pandemic period March 11 to May 31, 2020. CONCLUSION: One of the most striking changes in medical care settings during the COVID-19 pandemic was observed in surgical management strategies. The most significant among these were the limitation of elective surgical procedures and the prioritization of emergency or non-delayed oncological operations. One may speculate that the standstill of elective surgeries including the oncological surgeries might have long term impacts on the clinical outcomes of patients as well as the healthcare workers and organizations. KEY WORDS: COVID-19, Emergency, Oncology, Pathology, SARS-CoV-2, Surgery.