Elective Colorectal Cancer Surgery at the Oncologic Hub of Lombardy inside a Pandemic Covid-19 Area

ABSTRACT

Aim: At the end of May 2020, 37% of individuals positive for SARS-CoV2 in Italy were living in Lombardy and 49% of overall COVID-19- related deaths occurred there. Lombardy healthcare system assigned patients affected by colorectal cancer, suitable for surgery, to designated oncologic Hub hospitals. National Cancer Institute of Milan has been identified as one of those oncologic hub centers. The aim was both to treat patients in the hub waiting list as soon as possible and, simultaneously, remain a"COVID-free" center. Method(s) To manage patients from both, hub and institutional waiting list, prioritization criteria were defined and applied to each patient and internal protocol screening was carried out before treatment. All surgeons and healthcare workers were daily assessed too for symptoms. Result(s) 1 of the institutional waiting list patients and 7 of the hub list patients failed to pass the pre-hospitalization triage. Within this group, 4 patients resulted negative for SARS-CoV- 2;after a period of quarantine, they became negative and were admitted for hospitalization. 3 more patients resulted positive for SARS-CoV- 2 and despite the quarantine, one deceased for pneumonia, while other 2 patients remained asymptomatic and were admitted for hospitalization after running another triage protocol. A shorter surgical time in the hub patients was observed. Conclusion(s) Postoperative morbidity rates were similar in the two waiting list groups. In April 2020 all our staff members were tested for SARS-CoV- 2, and none resulted positive. The centralized management of colorectal cancer patients in an oncologic hub was effective during the COVID-19 outbreak.