Is Emergency Surgery Back to Pre-Covid-19 Era? Our Cohort Study.

Introduction: The aim of this study is to analyze the progress of hospitalizations and how the emergency operations in our Department of Medical and Surgical Sciences of the Foggia Hospital have changed qualitatively and quantitatively from pre-Covid-19 to today. Methods: Our cohort-study was conducted by analyzing four groups of patients admitted in emergency to our department from 2019 to 2022. Results: We observed a total of 150 patients for the group 1, 25 patients for the group 2, 71 patients for the group 3 and 110 for the group 4, of these 20 were emergency admission during 2019, 16 during 2020, 31 during 2021 and 10 during 2020 (p 0.05); 130 were elective admission during 2019, 9 during 2020, 40 during 2021 and 100 during 2022 (p 0.05). Of the emergency admissions 11 were operated during the no covid period in 2019, 14 during 2020, 29 during 2021, 6 during 2022. Conclusions: The contraction of hospitalizations for urgent and emergency conditions during the first lockdown has been accompanied by positive implications. The measures employed in hospitals to contain the infection determined a reduction in COVID cases, allowing the nearly complete resumption of the surgical activity provided in the pre-COVID era.

Late Bowel Iischemia and Colovaginal Fistula after Low Anterior Resection in a COVID-19 Patient.

The spread of SARS-CoV-2 in Italy has been rapid, with over 230.000 infections and 33.000 deaths (May 31st, 2020). The full impact of COVID19 on surgery is still unknown, as its effects on healthcare strategy, hospital infrastructure, staff, regional economy and colorectal disease progression, may not be evident before several months. No systematic reports are available about a higher incidence of COVID19 infections in patients with cancer. However, available data indicate that older people are more vulnerable, particularly when there are underlying health conditions such as chemotherapy or active cancer. Herein, we present the case of a patient with rectal cancer treated with pull-through technique low anterior rectal resection and coloanal anastomosis with protective loop ileostomy, complicated with Sars-CoV-2 infection and late (31st post-operative day) colic ischemia with colo-vaginal fistula. Late intestinal ischemia is a rare complication and can be secondary to several traditional factors, but certainly small vessel thrombosis related to Coronavirus disease must be taken into consideration.