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2020 ; 72
(2
): 281-289
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Continuing our work: transplant surgery and surgical oncology in a tertiary
referral COVID-19 center
#MMPMID32500431
Berardi G
; Colasanti M
; Levi Sandri GB
; Del Basso C
; Ferretti S
; Laurenzi A
; Guglielmo N
; Meniconi RL
; Antonini M
; D'Offizi G
; Ettorre GM
Updates Surg
2020[Jun]; 72
(2
): 281-289
PMID32500431
show ga
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.
|*Coronavirus Infections
[MESH]
|*Pandemics
[MESH]
|*Pneumonia, Viral
[MESH]
|*Tertiary Care Centers
[MESH]
|Aged
[MESH]
|COVID-19
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Italy
[MESH]
|Kidney Transplantation/*statistics & numerical data
[MESH]
|Liver Transplantation/*statistics & numerical data
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Neoplasms/*surgery
[MESH]
|Surgical Procedures, Operative/statistics & numerical data
[MESH]