Cargando…
Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center
COVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271142/ https://www.ncbi.nlm.nih.gov/pubmed/32500431 http://dx.doi.org/10.1007/s13304-020-00825-3 |
_version_ | 1783542032628711424 |
---|---|
author | Berardi, Giammauro Colasanti, Marco Levi Sandri, Giovanni Battista Del Basso, Celeste Ferretti, Stefano Laurenzi, Andrea Guglielmo, Nicola Meniconi, Roberto Luca Antonini, Mario D’Offizi, Gianpiero Ettorre, Giuseppe Maria |
author_facet | Berardi, Giammauro Colasanti, Marco Levi Sandri, Giovanni Battista Del Basso, Celeste Ferretti, Stefano Laurenzi, Andrea Guglielmo, Nicola Meniconi, Roberto Luca Antonini, Mario D’Offizi, Gianpiero Ettorre, Giuseppe Maria |
author_sort | Berardi, Giammauro |
collection | PubMed |
description | COVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a tertiary referral COVID-19 center. The official bulletins of the Italian National Institute for the Infectious Diseases “L. Spallanzani” were reviewed to retrieve the number of daily COVID-19 patients. Records of consecutive oncological and transplant procedures performed during the outbreak were reviewed. Patients with a high probability of postoperative intensive care unit (ICU) admission were considered as high risk and defined by an ASA score ≥ III and/or a Charlson Comorbidity Index (CCI) ≥ 6 and/or a Revised Cardiac Risk Index for Preoperative Risk (RCRI) ≥ 3. 72 patients were operated, including 12 (16.6%) liver and kidney transplantations. Patients had few comorbidities (26.3%), low ASA score (1.9 ± 0.5), CCI (3.7 ± 1.3), and RCRI (1.2 ± 0.6) and had overall a low risk of postoperative ICU admission. Few patients had liver cirrhosis (12.5%) or received preoperative systemic therapy (16.6%). 36 (50%) high-risk surgical procedures were performed, including major hepatectomies, pancreaticoduodenectomies, total gastrectomies, multivisceral resections, and transplantations. Despite this, only 15 patients (20.8%) were admitted to the ICU. Only oncologic cases and transplantations were performed during the COVID-19 outbreak. Careful selection of patients allowed to perform major cancer surgeries and transplantations without further stressing hospital resources, meanwhile minimizing collateral damage to patients. |
format | Online Article Text |
id | pubmed-7271142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-72711422020-06-04 Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center Berardi, Giammauro Colasanti, Marco Levi Sandri, Giovanni Battista Del Basso, Celeste Ferretti, Stefano Laurenzi, Andrea Guglielmo, Nicola Meniconi, Roberto Luca Antonini, Mario D’Offizi, Gianpiero Ettorre, Giuseppe Maria Updates Surg Original Article COVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a tertiary referral COVID-19 center. The official bulletins of the Italian National Institute for the Infectious Diseases “L. Spallanzani” were reviewed to retrieve the number of daily COVID-19 patients. Records of consecutive oncological and transplant procedures performed during the outbreak were reviewed. Patients with a high probability of postoperative intensive care unit (ICU) admission were considered as high risk and defined by an ASA score ≥ III and/or a Charlson Comorbidity Index (CCI) ≥ 6 and/or a Revised Cardiac Risk Index for Preoperative Risk (RCRI) ≥ 3. 72 patients were operated, including 12 (16.6%) liver and kidney transplantations. Patients had few comorbidities (26.3%), low ASA score (1.9 ± 0.5), CCI (3.7 ± 1.3), and RCRI (1.2 ± 0.6) and had overall a low risk of postoperative ICU admission. Few patients had liver cirrhosis (12.5%) or received preoperative systemic therapy (16.6%). 36 (50%) high-risk surgical procedures were performed, including major hepatectomies, pancreaticoduodenectomies, total gastrectomies, multivisceral resections, and transplantations. Despite this, only 15 patients (20.8%) were admitted to the ICU. Only oncologic cases and transplantations were performed during the COVID-19 outbreak. Careful selection of patients allowed to perform major cancer surgeries and transplantations without further stressing hospital resources, meanwhile minimizing collateral damage to patients. Springer International Publishing 2020-06-04 2020 /pmc/articles/PMC7271142/ /pubmed/32500431 http://dx.doi.org/10.1007/s13304-020-00825-3 Text en © Italian Society of Surgery (SIC) 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article Berardi, Giammauro Colasanti, Marco Levi Sandri, Giovanni Battista Del Basso, Celeste Ferretti, Stefano Laurenzi, Andrea Guglielmo, Nicola Meniconi, Roberto Luca Antonini, Mario D’Offizi, Gianpiero Ettorre, Giuseppe Maria Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title | Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title_full | Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title_fullStr | Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title_full_unstemmed | Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title_short | Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center |
title_sort | continuing our work: transplant surgery and surgical oncology in a tertiary referral covid-19 center |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271142/ https://www.ncbi.nlm.nih.gov/pubmed/32500431 http://dx.doi.org/10.1007/s13304-020-00825-3 |
work_keys_str_mv | AT berardigiammauro continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT colasantimarco continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT levisandrigiovannibattista continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT delbassoceleste continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT ferrettistefano continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT laurenziandrea continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT guglielmonicola continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT meniconirobertoluca continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT antoninimario continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT doffizigianpiero continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center AT ettorregiuseppemaria continuingourworktransplantsurgeryandsurgicaloncologyinatertiaryreferralcovid19center |