Thoracic surgery in the COVID-19 era: an Italian university hospital experience

Abstract Background Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span. Methods Data and re...

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Autores principales:	Riccardo Taje, Stefano Elia, Benedetto Cristino, Federico Tacconi, Gianluca Natali, Vincenzo Ambrogi, Eugenio Pompeo
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	COVID-19 SARS-COV-2 Thoracic Surgery Lung cancer Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/29ad2fe68321437a90e9ea0794dd3e7a
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spelling	oai:doaj.org-article:29ad2fe68321437a90e9ea0794dd3e7a2021-11-21T12:28:06ZThoracic surgery in the COVID-19 era: an Italian university hospital experience10.1186/s43057-021-00059-y2662-2203https://doaj.org/article/29ad2fe68321437a90e9ea0794dd3e7a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s43057-021-00059-yhttps://doaj.org/toc/2662-2203Abstract Background Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span. Methods Data and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate. Results Three patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 ± 13 vs. 28.2 ± 21; p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56; p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15; p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography. Conclusions Estimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group; there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care.Riccardo TajeStefano EliaBenedetto CristinoFederico TacconiGianluca NataliVincenzo AmbrogiEugenio PompeoSpringerOpenarticleCOVID-19SARS-COV-2Thoracic SurgeryLung cancerSurgeryRD1-811Diseases of the circulatory (Cardiovascular) systemRC666-701ENThe Cardiothoracic Surgeon, Vol 29, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-COV-2 Thoracic Surgery Lung cancer Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	COVID-19 SARS-COV-2 Thoracic Surgery Lung cancer Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701 Riccardo Taje Stefano Elia Benedetto Cristino Federico Tacconi Gianluca Natali Vincenzo Ambrogi Eugenio Pompeo Thoracic surgery in the COVID-19 era: an Italian university hospital experience
description	Abstract Background Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span. Methods Data and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate. Results Three patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 ± 13 vs. 28.2 ± 21; p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56; p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15; p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography. Conclusions Estimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group; there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care.
format	article
author	Riccardo Taje Stefano Elia Benedetto Cristino Federico Tacconi Gianluca Natali Vincenzo Ambrogi Eugenio Pompeo
author_facet	Riccardo Taje Stefano Elia Benedetto Cristino Federico Tacconi Gianluca Natali Vincenzo Ambrogi Eugenio Pompeo
author_sort	Riccardo Taje
title	Thoracic surgery in the COVID-19 era: an Italian university hospital experience
title_short	Thoracic surgery in the COVID-19 era: an Italian university hospital experience
title_full	Thoracic surgery in the COVID-19 era: an Italian university hospital experience
title_fullStr	Thoracic surgery in the COVID-19 era: an Italian university hospital experience
title_full_unstemmed	Thoracic surgery in the COVID-19 era: an Italian university hospital experience
title_sort	thoracic surgery in the covid-19 era: an italian university hospital experience
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/29ad2fe68321437a90e9ea0794dd3e7a
work_keys_str_mv	AT riccardotaje thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT stefanoelia thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT benedettocristino thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT federicotacconi thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT gianlucanatali thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT vincenzoambrogi thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience AT eugeniopompeo thoracicsurgeryinthecovid19eraanitalianuniversityhospitalexperience
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Thoracic surgery in the COVID-19 era: an Italian university hospital experience

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