The impact of COVID-19 pandemic on a tertiary referral proctology center: no one should be left behind.
Minerva Surg
; 77(1): 30-34, 2022 Feb.
Article
in English
| MEDLINE | ID: covidwho-1754139
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) has disrupted healthcare delivery. We aimed to describe a novel strategy to mitigate the impact of COVID-19 pandemic on a tertiary referral proctology center during the first wave of infection in Italy.METHODS:
All patients booked appointments at the Proctology Unit between March 9th and May 4th, 2020 were identified. Patients booked for a first visit underwent a structured remote consultation. Patients with perianal or sacrococcygeal abscesses, major anorectal bleeding, incoercible anal pain and red flags for malignancy were labelled as "non-deferrable." A flowchart was designed to comply with adequate assistance of proctologic patients. Demographics, clinical data and outcomes of in-office procedures were collected.RESULTS:
On a total of 548 booked visits, 198 (36.1%) were cancelled before remote consultation. Of the remaining 350, 112 (32.0%) attended a follow-up visit. Among 238 (68.0%) patients undergoing remote consultation, 88 (25.1%) were deemed "deferrable" and 148 (42.3%) "non-deferrable." Two (0.6%) were hospitalized for COVID-19 while waiting for an outpatient visit. Twenty-five of 88 (28.4%) deferrable patients cancelled their appointment as felt no longer necessary. A total of 45 of 148 (30.4%) non deferrable patients (mean age, 46 years; 31% females) underwent in-office procedures, most often related to anal abscess and/or fistula (48.9%). Final diagnosis of malignancy occurred in four cases. A 55% increase in the number of in-office procedures was noted compared to the previous year. None of the attending patients nor staff members resulted COVID-19 positive during the study period.CONCLUSIONS:
Despite the uncertainties accompanying the use of remote consultations in proctology, the results of this study may inform the development of strategies for restructuring activities in response to future emergencies of this magnitude.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Colorectal Surgery
/
Remote Consultation
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Minerva Surg
Year:
2022
Document Type:
Article
Affiliation country:
S2724-5691.21.08897-3
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