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新冠疫情期间意大利的结直肠手术:来自iCral研究小组的一项调查

Colorectal surgery in Italy during the Covid19 outbreak: a survey from the iCral study group.

作者信息

Caricato Marco, Baiocchi Gian Luca, Crafa Francesco, Scabini Stefano, Brisinda Giuseppe, Clementi Marco, Sica Giuseppe, Delrio Paolo, Longo Graziano, Anania Gabriele, de Manzini Nicolò, Amodio Pietro, Lucchi Andrea, Baldazzi Gianandrea, Garulli Gianluca, Patriti Alberto, Pirozzi Felice, Pavanello Maurizio, Carrara Alessandro, Campagnacci Roberto, Liverani Andrea, Muratore Andrea, Siquini Walter, De Luca Raffaele, Mancini Stefano, Borghi Felice, Di Cosmo Mariantonietta, Persiani Roberto, Pedrazzani Corrado, Scaramuzzi Matteo, Scatizzi Marco, Vettoretto Nereo, Totis Mauro, Gennai Andrea, Marini Pierluigi, Basti Massimo, Viola Massimo, Ruffo Giacomo, Catarci Marco

机构信息

Colorectal Surgery Unit, Campus BioMedico University Hospital, Rome, Italy.

General Surgery Unit 3, University and Spedali Civili, Brescia, Italy.

出版信息

Updates Surg. 2020 Jun;72(2):249-257. doi: 10.1007/s13304-020-00760-3. Epub 2020 May 20.

Abstract

BACKGROUND

The COVID19 pandemic had a deep impact on healthcare facilities in Italy, with profound reorganization of surgical activities. The Italian ColoRectal Anastomotic Leakage (iCral) study group collecting 43 Italian surgical centers experienced in colorectal surgery from multiple regions performed a quick survey to make a snapshot of the current situation.

METHODS

A 25-items questionnaire was sent to the 43 principal investigators of the iCral study group, with questions regarding qualitative and quantitative aspects of the surgical activity before and after the COVID19 outbreak.

RESULTS

Two-thirds of the centers were involved in the treatment of COVID19 cases. Intensive care units (ICU) beds were partially or totally reallocated for the treatment of COVID19 cases in 72% of the hospitals. Elective colorectal surgery for malignancy was stopped or delayed in nearly 30% of the centers, with less than 20% of them still scheduling elective colorectal resections for frail and comorbid patients needing postoperative ICU care. A significant reduction of the number of colorectal resections during the time span from January to March 2020 was recorded, with significant delay in treatment in more than 50% of the centers.

DISCUSSION

Our survey confirms that COVID19 outbreak is severely affecting the activity of colorectal surgery centers participating to iCral study group. This could impact the activity of surgical centers for many months after the end of the emergency.

摘要

背景

新冠疫情对意大利的医疗设施产生了深远影响,外科手术活动也进行了重大调整。意大利结直肠吻合口漏(iCral)研究小组收集了来自多个地区的43个意大利结直肠手术经验丰富的外科中心的数据,进行了一项快速调查以了解当前情况。

方法

向iCral研究小组的43名主要研究者发送了一份包含25个条目的问卷,问题涉及新冠疫情爆发前后外科手术活动的定性和定量方面。

结果

三分之二的中心参与了新冠病例的治疗。72%的医院将重症监护病房(ICU)床位部分或全部重新分配用于治疗新冠病例。近30%的中心停止或推迟了恶性肿瘤的择期结直肠手术,其中不到20%的中心仍在为需要术后ICU护理的体弱和合并症患者安排择期结直肠切除术。记录显示,2020年1月至3月期间结直肠切除术的数量显著减少,超过50%的中心治疗出现明显延迟。

讨论

我们的调查证实,新冠疫情爆发正在严重影响参与iCral研究小组的结直肠手术中心的活动。这可能会在紧急情况结束后的许多个月内影响外科中心的活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3034/7238958/209f0303eb1b/13304_2020_760_Fig1_HTML.jpg

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