Impact of COVID-19 outbreak on esophageal cancer surgery in Northern Italy: lessons learned from a multicentric snapshot.

Autor: Rebecchi F; Department of Surgical Sciences, University of Turin, Turin, Italy., Arolfo S; Department of Surgical Sciences, University of Turin, Turin, Italy., Ugliono E; Department of Surgical Sciences, University of Turin, Turin, Italy., Morino M; Department of Surgical Sciences, University of Turin, Turin, Italy., Asti E; Department of General and Foregut Surgery, University of Milan, IRCCS, Policlinico San Donato, Milan, Italy., Bonavina L; Department of General and Foregut Surgery, University of Milan, IRCCS, Policlinico San Donato, Milan, Italy., Borghi F; General and Oncologic Surgery Unit, Santa Croce e Carle Hospital, Cuneo, Italy., Coratti A; Division of Oncological and Robotic Surgery, Careggi University Hospital of Florence, Florence, Italy., Cossu A; Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy., De Manzoni G; General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy., De Pascale S; Digestive Surgery, European Institute of Oncology -IRCCS, Milan, Italy., Ferrari GC; Mini-Invasive Oncological Surgical Department, Niguarda Hospital, Milan, Italy., Fumagalli Romario U; Digestive Surgery, European Institute of Oncology -IRCCS, Milan, Italy., Giacopuzzi S; General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy., Gualtierotti M; Mini-Invasive Oncological Surgical Department, Niguarda Hospital, Milan, Italy., Guglielmetti M; Thoracic Surgery, S. Anna Hospital, Como, Italy., Merigliano S; Center for Esophageal Disease, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padua, Italy., Pallabazzer G; Esophageal Surgery Unit, University Hospital of Pisa, Pisa, Italy., Parise P; Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy., Peri A; Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy., Pietrabissa A; Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy., Rosati R; Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy., Santi S; Esophageal Surgery Unit, University Hospital of Pisa, Pisa, Italy., Tribuzi A; Division of Oncological and Robotic Surgery, Careggi University Hospital of Florence, Florence, Italy., Valmasoni M; Center for Esophageal Disease, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padua, Italy., Viganò J; Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy., Weindelmayer J; General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy.
Jazyk: angličtina
Zdroj: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2021 Jun 14; Vol. 34 (6).
DOI: 10.1093/dote/doaa124
Abstrakt: Coronavirus Disease-19 (COVID-19) outbreak has significantly burdened healthcare systems worldwide, leading to reorganization of healthcare services and reallocation of resources. The Italian Society for Study of Esophageal Diseases (SISME) conducted a national survey to evaluate changes in esophageal cancer management in a region severely struck by COVID-19 pandemic. A web-based questionnaire (26 items) was sent to 12 SISME units. Short-term outcomes of esophageal resections performed during the lockdown were compared with those achieved in the same period of 2019. Six (50%) centers had significant restrictions in their activity. However, overall number of resections did not decrease compared to 2019, while a higher rate of open esophageal resections was observed (40 vs. 21.7%; P = 0.034). Surgery was delayed in 24 (36.9%) patients in 6 (50%) centers, mostly due to shortage of anesthesiologists, and occupation of intensive care unit beds from intubated COVID-19 patients. Indications for neoadjuvant chemo (radio) therapy were extended in 14% of patients. Separate COVID-19 hospital pathways were active in 11 (91.7%) units. COVID-19 screening protocols included nasopharyngeal swab in 91.7%, chest computed tomography scan in 8.3% and selective use of lung ultrasound in 75% of units. Postoperative interstitial pneumonia occurred in 1 (1.5%) patient. Recovery from COVID-19 pandemic was characterized by screening of patients in all units, and follow-up outpatient visits in only 33% of units. This survey shows that clinical strategies differed considerably among the 12 SISME centers. Evidence-based guidelines are needed to support the surgical esophageal community and to standardize clinical practice in case of further pandemics.
(© The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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