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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...

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Autores principales: 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
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
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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.
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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
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