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1.
In Vivo ; 35(1): 635-639, 2021.
Article in English | MEDLINE | ID: covidwho-1011856

ABSTRACT

BACKGROUND/AIM: The perspective validation of a selective approach in patients undergoing breast cancer surgery was performed in order to assess whether patients as well as Health Care Workers (HCWs) were exposed to any undue risk of COVD-19 infection. PATIENTS AND METHODS: From March 9th to June 9th 2020, 207 patients were phone-triaged by a dedicated Breast Care Nurse; a patient-tailored program was adopted with the aim of avoiding hospitalization of SARS-CoV-2 symptomatic patients, with a careful prioritization of surgical procedures according to specific disease features. RESULTS: Two hundred and three out of 207 patients underwent operation; seven patients were temporarily excluded because they tested positive at phone triage (n=3), or in-hospital triage (n=3); another asymptomatic patient with negative NP swab tested IgM Ab-positive so that surgery was re-scheduled two weeks later. Four patients had no surgery; one of them was reconsidered for neoadjuvant chemotherapy (NAC) after testing positive at phone triage; three patients were excluded because they were already hospitalized for COVID-19. Overall, mean in-hospital stay was 2.2 days (±SD, 0.7) and, after hospital discharge, no patient required readmission. CONCLUSION: This preventive program avoided any COVID-19 infection among patients and HCWs, so that an elective breast cancer surgical procedure can be safely and timely pursued without affecting the oncologic outcome.


Subject(s)
Breast Neoplasms/surgery , COVID-19/prevention & control , Health Personnel/statistics & numerical data , Mastectomy/methods , Preventive Health Services/methods , SARS-CoV-2/isolation & purification , Adult , Breast Neoplasms/therapy , COVID-19/epidemiology , COVID-19/virology , Female , Humans , Length of Stay/statistics & numerical data , Medical Oncology/methods , Middle Aged , Pandemics , Reproducibility of Results , SARS-CoV-2/physiology , Triage/methods
2.
Updates Surg ; 72(2): 269-280, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-601789

ABSTRACT

INTRODUCTION: Recently, Italy has been heavily hit by COVID-19 pandemic and today it is still one of the most affected countries in the world. The subsequent necessary lockdown decreed by the Italian Government had an outstanding impact on the daily life of the entire population, including that of Italian surgical residents' activity. Our survey aims to evaluate the impact of COVID-19 on the training programme of Italian surgical residents. MATERIALS AND METHODS: We designed a 12-item-electronic anonymous questionnaire on SurveyMonkey© web application. The survey was composed of different sections concerning demographic characteristics and impacts of COVID-19 on the concrete participation in clinical, surgical and research activities. Future perspectives of responders after the pandemic were also investigated. RESULTS: Eighty hundred responses were collected, and 756 questionnaires were considered eligible to be included in the study analysis. Almost 35 and 27% of respondents experienced, respectively, complete interruption of surgical and clinical activities. A subgroup analysis, comparing the COVID-19 impact on clinical activities with demographics data, showed a statistically significant difference related to specialties (p = 0.0062) and Italian regions (p < 0.0001). Moreover, 112 residents have been moved to non-surgical units dealing with COVID-19 or, in some case, they voluntarily decided to interrupt their residency programme to support the ongoing emergency. CONCLUSION: Our survey demonstrated that COVID-19 pandemic has severely impacted the educational programme of Italian surgical residents. Despite many regional differences, this survey highlighted the overall shortage of planning in the re-allocation of resources facing this unexpected health emergency.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Specialties, Surgical/education , COVID-19 , Humans , Internship and Residency/organization & administration , Italy , Societies, Medical , Surveys and Questionnaires
3.
In Vivo ; 34(3 Suppl): 1667-1673, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-527842

ABSTRACT

BACKGROUND: COVID-19 pandemic required a marked re-allocation of healthcare resources, including at Breast Units. A patient-tailored program was developed to assess its efficacy regarding prevention of COVID-19 infection among patients with breast cancer undergoing surgery and healthcare workers (HCWs). PATIENTS AND METHODS: From March 9th to April 9th 2020, 91 patients were selected for elective surgery by means of: i) Pre-hospital screening aimed at avoiding hospitalization of symptomatic or suspicious COVID-19 patients, and ii) prioritisation of surgical procedure according to specific disease features. RESULTS: Eighty-five patients (93.4%) were fit for surgery, while five patients (5.5%) were temporarily excluded through 'telephone triage'; another two patients were excluded at in-hospital triage. A total of 71 out of 85 patients (83.5%) were diagnosed with invasive cancer, most of whom were undergoing breast-conserving surgery (61 out of 85 patients, 71.8%). The mean in-hospital stay was 2.2 days (SD=0.7 days). After hospital discharge, no patient needed re-admission due to post-operative complications; moreover, no COVID-19 infection among patients or HCWs was detected. CONCLUSION: Safe breast cancer surgery was accomplished for both patients and HCWs by means of a careful preoperative selection of patients and in-hospital preventative measures. This screening program can be transferred to high-volume Breast Units and it may be useful in implementing European Community recommendations for prevention of COVID-19 infection.


Subject(s)
Breast Neoplasms/surgery , Carcinoma/surgery , Coronavirus Infections/prevention & control , Elective Surgical Procedures/statistics & numerical data , Infection Control/methods , Mastectomy/statistics & numerical data , Pandemics/prevention & control , Patient Selection , Pneumonia, Viral/prevention & control , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/nursing , COVID-19 , COVID-19 Testing , Carcinoma/drug therapy , Carcinoma/epidemiology , Carcinoma/nursing , Clinical Laboratory Techniques , Combined Modality Therapy , Coronavirus Infections/diagnosis , Female , Hospital Units/organization & administration , Humans , Italy/epidemiology , Length of Stay/statistics & numerical data , Lymphatic Metastasis/diagnostic imaging , Lymphoscintigraphy , Mastectomy, Segmental/statistics & numerical data , Neoadjuvant Therapy , Patient Discharge , Protective Devices , Sentinel Lymph Node Biopsy , Symptom Assessment , Telemedicine , Triage
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