Safety of urologic elective surgery in a covid-hospital

ABSTRACT

Introduction: To demonstrate safety of a new internal protocol for patients and health workers adopted for elective urologic surgical activity during COVID-19 pandemic. Materials and methods: We have retrospectively evaluated 86 patients who underwent elective surgery in the urology department of IRCCS Policlinico San Donato, from March 9th to May 8th, 2020. Our institution became a first line hospital for COVID-19 patients since March 2020. We identified non-deferrable patients that needed to be treated within one month. All patients included have followed a dedicated pathway from the day-hospital till the discharge. Clinical data, as nasopharyngeal swabs, chest X-ray, type of anesthesia, type of surgical procedure and days of hospitalization were collected. Moreover, individual risk factors for COVID-19 pneumonia, as advanced age, ongoing malignancy, high blood pressure and coronary artery disease, were analyzed. All patients were interviewed after a minimum post discharge time of 14 days to find out if any of them had developed general and Covid-related complications. Results: The study population included 66 (76.75%) men and 20 (23.25%) women, aged between 17 and 90 years old. We have performed eighty-eight (88) preoperative screenings and two (2) patients were excluded, due to exclusion criteria. Overall, 63 (71.60%) patients underwent oncological procedures while only 23 (28.40%) patients underwent non-oncological surgery. The average number of hospitalization days was 2.39 ± 2.21. After at least 14 days after discharge (25.00 ± 10.35 days), we phone interviewed all patients to check their conditions. No patients included in the study showed symptoms related to COVID-19, except for 2 (2.32%) who manifested coryza, 28 and 35 days after discharge respectively. We also analyzed clinical characteristics of the study participants in relation to develop SARS CoV-2. None of patient developed Covid-19 postoperatively and in addition, none of hospital workers that were part of this pathway got the Covid-19 infection. Conclusions: The duration of pandemic period is undefined;therefore, our protocol could be considered a good model for every type of surgery and its application could ensure a continuous treatment for non-deferrable conditions, even during healthcare emergencies in a safe way for both the patients and health workers.