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1.
Updates Surg ; 73(2): 745-752, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1002181

ABSTRACT

Since the beginning of the pandemic due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), several articles reported negative outcomes in surgery of infected patients. Aim of this study is to report results of patients with COVID-19-positive swab, in the perioperative period after surgery. Data of COVID-19-positive patients undergoing emergent or oncological surgery, were collected in a retrospective, multicenter study, which involved 20 Italian institutions. Collected parameters were age, sex, body mass index, COVID-19-related symptoms, patients' comorbidities, surgical procedure, personal protection equipment (PPE) used in operating rooms, rate of postoperative infection among healthcare staff and complications, within 30-postoperative days. 68 patients, who underwent surgery, resulted COVID-19-positive in the perioperative period. Symptomatic patients were 63 (92.5%). Fever was the main symptom in 36 (52.9%) patients, followed by dyspnoea (26.5%) and cough (13.2%). We recorded 22 (32%) intensive care unit admissions, 23 (33.8%) postoperative pulmonary complications and 15 (22%) acute respiratory distress syndromes. As regards the ten postoperative deaths (14.7%), 6 cases were related to surgical complications. One surgeon, one scrub nurse and two circulating nurses were infected after surgery due to the lack of specific PPE. We reported less surgery-related pulmonary complications and mortality in Sars-CoV-2-infected patients, than in literature. Emergent and oncological surgery should not be postponed, but it is mandatory to use full PPE, and to adopt preoperative screenings and strategies that mitigate the detrimental effect of pulmonary complications, mostly responsible for mortality.


Subject(s)
COVID-19/complications , COVID-19/epidemiology , Elective Surgical Procedures/mortality , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Postoperative Complications/mortality , Adult , Aged , Aged, 80 and over , COVID-19/transmission , Emergencies , Female , Humans , Infection Control/organization & administration , Italy/epidemiology , Male , Middle Aged , Occupational Exposure/statistics & numerical data , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Retrospective Studies , Risk Factors , SARS-CoV-2
2.
Updates Surg ; 72(2): 249-257, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-324541

ABSTRACT

BACKGROUND: The COVID19 pandemic had a deep impact on healthcare facilities in Italy, with profound reorganization of surgical activities. The Italian ColoRectal Anastomotic Leakage (iCral) study group collecting 43 Italian surgical centers experienced in colorectal surgery from multiple regions performed a quick survey to make a snapshot of the current situation. METHODS: A 25-items questionnaire was sent to the 43 principal investigators of the iCral study group, with questions regarding qualitative and quantitative aspects of the surgical activity before and after the COVID19 outbreak. RESULTS: Two-thirds of the centers were involved in the treatment of COVID19 cases. Intensive care units (ICU) beds were partially or totally reallocated for the treatment of COVID19 cases in 72% of the hospitals. Elective colorectal surgery for malignancy was stopped or delayed in nearly 30% of the centers, with less than 20% of them still scheduling elective colorectal resections for frail and comorbid patients needing postoperative ICU care. A significant reduction of the number of colorectal resections during the time span from January to March 2020 was recorded, with significant delay in treatment in more than 50% of the centers. DISCUSSION: Our survey confirms that COVID19 outbreak is severely affecting the activity of colorectal surgery centers participating to iCral study group. This could impact the activity of surgical centers for many months after the end of the emergency.


Subject(s)
Colon/surgery , Coronavirus Infections/epidemiology , Digestive System Surgical Procedures/statistics & numerical data , Disease Outbreaks , Elective Surgical Procedures/statistics & numerical data , Pneumonia, Viral/epidemiology , Rectum/surgery , COVID-19 , Humans , Italy/epidemiology , Pandemics , Surveys and Questionnaires , Time Factors
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