Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center

Giammauro Berardi, Marco Colasanti, Giovanni Battista Levi Sandri, Celeste Del Basso, Stefano Ferretti, Andrea Laurenzi, Nicola Guglielmo, Roberto Luca Meniconi, Mario Antonini, Gianpiero D’Offizi, Giuseppe Maria Ettorre

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalUpdates in Surgery
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • COVID-19
  • General surgery
  • Surgical oncology

ASJC Scopus subject areas

  • Surgery

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    Berardi, G., Colasanti, M., Levi Sandri, G. B., Del Basso, C., Ferretti, S., Laurenzi, A., Guglielmo, N., Meniconi, R. L., Antonini, M., D’Offizi, G., & Ettorre, G. M. (Accepted/In press). Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center. Updates in Surgery, 1-9. https://doi.org/10.1007/s13304-020-00825-3