Department of Surgery, Division of Breast Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
Quality and Risk Management, Medical Direction, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
J Exp Clin Cancer Res. 2020 Aug 27;39(1):171. doi: 10.1186/s13046-020-01683-y.
The Covid-19 pandemic has challenged hard the national health systems worldwide. According to the national policy issued in March 2020 in response to the evolving Covid-19 pandemic, several hospitals were re-configured as Covid-19 centers and elective surgery procedures were rescheduled according to the most recent recommendations. In addition, Covid-19 protected cancer hubs were established, including the Regina Elena National Cancer Institute of Rome, Central Italy. At our Institute, the Breast Surgery Department continued working under the sign of a multidisciplinary approach. The number of professional figures involved in case evaluation was reduced to a minimum and interactions took place in the full respect of the required safety measures. Treatments for benign disease, pure prophylactic surgery and elective reconstructive procedures were all postponed and priority was assigned to the histologically-proven malignant breast tumors and highly suspicious lesions. From March 15th though April 30th 2020, we treated a total of 79 patients. This number is fully consistent with the average quantitative standards reached by our Department under ordinary circumstances. Patients were mostly discharged the day after surgery and none was readmitted due to surgery-related late complications. More generally, post-operative complications rates were unexpectedly low, particularly in light of the relatively high number of reconstructive procedures performed in this emergency situation. A strict follow up was performed based on the close contact with the surgical staff by telephone, messaging apps and telemedicine.Patients ascertainment for their Covid-19 status prior to hospital admission and hospital discharge allowed to maintain the "no-Covid-19" status at our Institution. In addition, during the aforementioned time window, none of the care providers developed SARS-CoV-2 infection or disease, as shown by the results of anti-SARS-CoV-2 immunoglobulin M and G profiling. In conclusions, elective breast cancer surgery procedures were successfully performed in a lockdown situation due to a novel viral pandemic. The well-coordinated regional and hospital efforts in terms of medical resource re-allocation and definition of clinical priorities allowed to maintain high quality standards of breast cancer care while ensuring safety to the cancer patients and care providers involved.
新冠疫情对全球各国的卫生系统带来了严峻挑战。2020 年 3 月，中国政府根据疫情发展情况，发布了相关国家政策，多家医院被重新配置为新冠定点医院，并根据最新建议重新安排择期手术。此外，还建立了新冠防护癌症中心，包括意大利中部的罗马 Regina Elena 国家癌症研究所。在我院，乳腺外科继续采用多学科综合治疗模式开展工作。参与病例评估的专业人员数量减少到最低限度，并在充分遵守所需安全措施的情况下进行交流。良性疾病的治疗、单纯预防性手术和择期重建手术均被推迟，优先考虑组织学证实的恶性乳腺肿瘤和高度疑似病变。2020 年 3 月 15 日至 4 月 30 日，我们共治疗了 79 名患者。这一数字与我们科室在正常情况下的平均数量标准完全一致。患者术后次日大多出院，无一人因手术相关晚期并发症再次入院。更普遍的是，术后并发症发生率出乎意料地低，尤其是在这种紧急情况下进行了相对较多的重建手术后。我们通过电话、短信应用程序和远程医疗与外科工作人员保持密切联系，对患者进行严格的随访。患者在入院和出院前都要进行新冠状态检测，以确保我院保持“无新冠”状态。此外，在上述时间段内，没有医护人员感染 SARS-CoV-2，这一点可以从 SARS-CoV-2 免疫球蛋白 M 和 G 分析结果中看出。总之，由于新的病毒性大流行，我们在封锁期间成功地进行了择期乳腺癌手术。区域和医院在医疗资源重新配置和临床重点定义方面的协调努力，使我们在确保参与癌症患者和医护人员安全的同时，保持了高质量的乳腺癌护理标准。
