Quantitative assessment of the impact of COVID-19 pandemic on pancreatic surgery: an Italian multicenter analysis of 1423 cases from 10 tertiary referral centers.

COVID-19 Communicable Disease Control Humans Pandemics SARS-CoV-2 Tertiary Care Centers
COVID Pancreatic disease Pancreatic surgery Pandemic

Journal

Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818

Informations de publication

Date de publication:
Feb 2022
Historique:
received: 09 04 2021
accepted: 16 09 2021
pubmed: 25 11 2021
medline: 12 2 2022
entrez: 24 11 2021
Statut: ppublish

Résumé

Few evidences are present on the consequences of coronavirus disease 2019 (COVID-19) pandemic on pancreatic surgery. Aim of this study is to evaluate how COVID-19 influenced the diagnostic and therapeutic pathways of surgical pancreatic diseases. A comparative analysis of surgical volumes and clinical, surgical and perioperative outcomes in ten Italian referral centers was conducted between the first semester 2020 and 2019. One thousand four hundred and twenty-three consecutive patients were included in the analysis: 638 from 2020 and 785 from 2019. Surgical volume in 2020 decreased by 18.7% (p < 0.0001). Benign/precursors diseases (- 43.4%; p < 0.0001) and neuroendocrine tumors (- 33.6%; p = 0.008) were the less treated diseases. No difference was reported in terms of discussed cases at the multidisciplinary tumor board (p = 0.43), mean time between diagnosis and neoadjuvant treatment (p = 0.91), indication to surgery and surgical resection (p = 0.35). Laparoscopic and robot-assisted procedures dropped by 45.4% and 61.9%, respectively, during the lockdown weeks of 2020. No difference was documented for post-operative intensive care unit accesses (p = 0.23) and post-operative mortality (p = 0.06). The surgical volume decrease in 2020 will potentially lead, in the near future, to the diagnosis of a higher rate of advanced stage diseases. However, the reassessment of the Italian Health Service kept guarantying an adequate level of care in tertiary referral centers. Clinicaltrials.gov ID: NCT04380766.

Identifiants

DOI: 10.1007/s13304-021-01171-8 PMID: 34817837 PMC: PMC8611384
pubmed: 34817837
doi: 10.1007/s13304-021-01171-8
pii: 10.1007/s13304-021-01171-8
pmc: PMC8611384
doi:

Banques de données

ClinicalTrials.gov
['NCT04380766']

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

255-266

Informations de copyright

© 2021. Italian Society of Surgery (SIC).

Références

Wu Z, McGoogan JM (2020) Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 323(13):1239–1242. https://doi.org/10.1001/jama.2020.2648
doi: 10.1001/jama.2020.2648 pubmed: 32091533
Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, Agha M, Agha R (2020) The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg 78:185–193. https://doi.org/10.1016/j.ijsu.2020.04.018
doi: 10.1016/j.ijsu.2020.04.018 pubmed: 32305533 pmcid: 7162753
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, Iosifidis C, Agha R (2020) Corrigendum to “World Health Organization declares global emergency: a review of the 2019 novel Coronavirus (COVID-19)” [Int. J. Surg. 76 (2020) 71-76]. Int J Surg 77:217. https://doi.org/10.1016/j.ijsu.2020.03.036
doi: 10.1016/j.ijsu.2020.03.036 pubmed: 32305321 pmcid: 7159865
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W, China Novel Coronavirus I, Research T (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382(8):727–733. https://doi.org/10.1056/NEJMoa2001017
doi: 10.1056/NEJMoa2001017 pubmed: 31978945 pmcid: 31978945
(2020) Infografica web - Dati della Sorveglianza integrata COVID-19 in Italia. https://www.epicentro.iss.it/coronavirus/sars-cov-2-dashboard
Collaborative CO (2020) Global guidance for surgical care during the COVID-19 pandemic. Br J Surg 107(9):1097–1103. https://doi.org/10.1002/bjs.11646
doi: 10.1002/bjs.11646
Bartlett DL, Howe JR, Chang G, Crago A, Hogg M, Karakousis G, Levine E, Maker A, Mamounas E, McGuire K, Merchant N, Shibata D, Sohn V, Solorzano C, Turaga K, White R, Yang A, Yoon S, Society of Surgical O (2020) Management of cancer surgery cases during the COVID-19 pandemic: considerations. Ann Surg Oncol 27(6):1717–1720. https://doi.org/10.1245/s10434-020-08461-2
doi: 10.1245/s10434-020-08461-2 pubmed: 32270420
Ilic M, Ilic I (2016) Epidemiology of pancreatic cancer. World J Gastroenterol 22(44):9694–9705. https://doi.org/10.3748/wjg.v22.i44.9694
doi: 10.3748/wjg.v22.i44.9694 pubmed: 27956793 pmcid: 5124974
Strijker M, Chen JW, Mungroop TH, Jamieson NB, van Eijck CH, Steyerberg EW, Wilmink JW, Groot Koerkamp B, van Laarhoven HW, Besselink MG (2019) Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer. Br J Surg 106(4):342–354. https://doi.org/10.1002/bjs.11111
doi: 10.1002/bjs.11111 pubmed: 30758855
Fogel EL, Shahda S, Sandrasegaran K, DeWitt J, Easler JJ, Agarwal DM, Eagleson M, Zyromski NJ, House MG, Ellsworth S, El Hajj I, O’Neil BH, Nakeeb A, Sherman S (2017) A multidisciplinary approach to pancreas cancer in 2016: a review. Am J Gastroenterol 112(4):537–554. https://doi.org/10.1038/ajg.2016.610
doi: 10.1038/ajg.2016.610 pubmed: 28139655 pmcid: 5659272
Fong Y, Gonen M, Rubin D, Radzyner M, Brennan MF (2005) Long-term survival is superior after resection for cancer in high-volume centers. Ann Surg 242(4):540–544. https://doi.org/10.1097/01.sla.0000184190.20289.4b (discussion 544–547)
doi: 10.1097/01.sla.0000184190.20289.4b pubmed: 16192814 pmcid: 1402350
Quero G, Salvatore L, Fiorillo C, Bagala C, Menghi R, Maria B, Cina C, Laterza V, Di Stefano B, Maratta MG, Ribelli M, Galiandro F, Mattiucci GC, Brizi MG, Genco E, D’Aversa F, Zileri L, Attili F, Larghi A, Perri V, Inzani F, Gasbarrini A, Valentini V, Costamagna G, Manfredi R, Tortora G, Alfieri S (2021) The impact of the multidisciplinary tumor board (MDTB) on the management of pancreatic diseases in a tertiary referral center. ESMO Open 6(1):100010. https://doi.org/10.1016/j.esmoop.2020.100010
doi: 10.1016/j.esmoop.2020.100010 pubmed: 33399076
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS, China Medical Treatment Expert Group for C (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382(18):1708–1720. https://doi.org/10.1056/NEJMoa2002032
doi: 10.1056/NEJMoa2002032 pubmed: 32109013 pmcid: 32109013
Covino M, Sandroni C, Santoro M, Sabia L, Simeoni B, Bocci MG, Ojetti V, Candelli M, Antonelli M, Gasbarrini A, Franceschi F (2020) Predicting intensive care unit admission and death for COVID-19 patients in the emergency department using early warning scores. Resuscitation 156:84–91. https://doi.org/10.1016/j.resuscitation.2020.08.124
doi: 10.1016/j.resuscitation.2020.08.124 pubmed: 32918985 pmcid: 7480278
Ojetti V, Saviano A, Covino M, Acampora N, Troiani E, Franceschi F, group GAC (2020) COVID-19 and intestinal inflammation: role of fecal calprotectin. Dig Liver Dis 52(11):1231–1233. https://doi.org/10.1016/j.dld.2020.09.015
doi: 10.1016/j.dld.2020.09.015 pubmed: 33060042 pmcid: 7508507
Oba A, Stoop TF, Lohr M, Hackert T, Zyromski N, Nealon WH, Unno M, Schulick RD, Al-Musawi MH, Wu W, Zhao Y, Satoi S, Wolfgang CL, Abu Hilal M, Besselink MG, Del Chiaro M, Pancreas Club EPCCPSAECoMIPSSGoPTfPCSGoPDAw, International Study Group on Cystic Tumors of the P (2020) Global survey on pancreatic surgery during the COVID-19 pandemic. Ann Surg 272(2):e87–e93. https://doi.org/10.1097/SLA.0000000000004006
doi: 10.1097/SLA.0000000000004006 pubmed: 32675507
(2020) Gazzetta Uf ciale della Repubblica Italiana GU Serie Generale n 64 del 11/03/2020. https://www.gazzettaufciale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2020-03-11&atto.codiceRedazionale=20A01605&elenco30giorni=false
Hata T, Motoi F, Ishida M, Naitoh T, Katayose Y, Egawa S, Unno M (2016) Effect of hospital volume on surgical outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis. Ann Surg 263(4):664–672. https://doi.org/10.1097/SLA.0000000000001437
doi: 10.1097/SLA.0000000000001437 pubmed: 26636243
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
doi: 10.1097/01.sla.0000133083.54934.ae pubmed: 15273542 pmcid: 15273542
Board WCoTE (2019) Digestive system tumours, 5th edn. IARC
Italia Mds-Mi (2020) http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html-/b0c68bce2cce478eaac82fe38d4138b1
Curigliano G, Banerjee S, Cervantes A, Garassino MC, Garrido P, Girard N, Haanen J, Jordan K, Lordick F, Machiels JP, Michielin O, Peters S, Tabernero J, Douillard JY, Pentheroudakis G, Panel m (2020) Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus. Ann Oncol 31(10):1320–1335. https://doi.org/10.1016/j.annonc.2020.07.010
doi: 10.1016/j.annonc.2020.07.010 pubmed: 32745693
Spinelli A, Pellino G (2020) COVID-19 pandemic: perspectives on an unfolding crisis. Br J Surg 107(7):785–787. https://doi.org/10.1002/bjs.11627
doi: 10.1002/bjs.11627 pubmed: 32191340 pmcid: 7228411
Catanese S, Pentheroudakis G, Douillard JY, Lordick F (2020) ESMO management and treatment adapted recommendations in the COVID-19 era: pancreatic cancer. ESMO Open. https://doi.org/10.1136/esmoopen-2020-000804
doi: 10.1136/esmoopen-2020-000804 pubmed: 32423899 pmcid: 7239531
Brauer DG, Strand MS, Sanford DE, Kushnir VM, Lim KH, Mullady DK, Tan BR Jr, Wang-Gillam A, Morton AE, Ruzinova MB, Parikh PJ, Narra VR, Fowler KJ, Doyle MB, Chapman WC, Strasberg SS, Hawkins WG, Fields RC (2017) Utility of a multidisciplinary tumor board in the management of pancreatic and upper gastrointestinal diseases: an observational study. HPB 19(2):133–139. https://doi.org/10.1016/j.hpb.2016.11.002
doi: 10.1016/j.hpb.2016.11.002 pubmed: 27916436
Pawlik TM, Laheru D, Hruban RH, Coleman J, Wolfgang CL, Campbell K, Ali S, Fishman EK, Schulick RD, Herman JM, Johns Hopkins Multidisciplinary Pancreas Clinic T (2008) Evaluating the impact of a single-day multidisciplinary clinic on the management of pancreatic cancer. Ann Surg Oncol 15(8):2081–2088. https://doi.org/10.1245/s10434-008-9929-7
doi: 10.1245/s10434-008-9929-7 pubmed: 18461404 pmcid: 2907242
Hwang ES, Balch CM, Balch GC, Feldman SM, Golshan M, Grobmyer SR, Libutti SK, Margenthaler JA, Sasidhar M, Turaga KK, Wong SL, McMasters KM, Tanabe KK (2020) Surgical oncologists and the COVID-19 pandemic: guiding cancer patients effectively through turbulence and change. Ann Surg Oncol 27(8):2600–2613. https://doi.org/10.1245/s10434-020-08673-6
doi: 10.1245/s10434-020-08673-6 pubmed: 32535870
Brady R (2020) Shared experience from China-an interview with Xiaohua Jiang. European Society of Coloproctology April 2:2020
Lapidus N, Zhou X, Carrat F, Riou B, Zhao Y, Hejblum G (2020) Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic. Ann Intensive Care 10(1):135. https://doi.org/10.1186/s13613-020-00749-6
doi: 10.1186/s13613-020-00749-6 pubmed: 33063241 pmcid: 7561433
Olivieri A, Palu G, Sebastiani G (2020) Covid-19 cumulative incidence, intensive care and mortality in Italian regions compared to selected European countries. Int J Infect Dis. https://doi.org/10.1016/j.ijid.2020.10.070
doi: 10.1016/j.ijid.2020.10.070 pubmed: 33130199 pmcid: 7833245

Auteurs

Giuseppe Quero (G)

Department of Surgery, Gemelli Pancreatic Center, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.

Nicolò Pecorelli (N)

Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Salvatore Paiella (S)

Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.

Claudio Fiorillo (C)

Department of Surgery, Gemelli Pancreatic Center, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy. claudio.fiorillo@policlinicogemelli.it.
CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome, Italy. claudio.fiorillo@policlinicogemelli.it.

Maria Chiara Petrone (MC)

Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Fausto Rosa (F)

Department of Surgery, Gemelli Pancreatic Center, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.

Giovanni Capretti (G)

Humanitas Clinical and Research Center-IRCCS, Rozzano, MI, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.

Vito Laterza (V)

Department of Surgery, Gemelli Pancreatic Center, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome, Italy.

Emanuele Kauffmann (E)

Chirurgia Generale Universitaria dell'Ospedale di Cisanello, Via Paradisa, 2, 56124, Pisa, Italy.

Sara Nobile (S)

Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.

Giovanni Butturini (G)

Casa di Cura Pederzoli, Via Monte Baldo 24, 37019, Peschiera del Garda, VR, Italy.

Giovanni Ferrari (G)

Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.

Andrea Coratti (A)

Division of Surgical Oncology and Robotics, Department of Oncology, Careggi University Hospital, Florence, Italy.

Riccardo Casadei (R)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Vincenzo Mazzaferro (V)

HPB Surgery and Liver Transplantation, Department of Oncology, Istituto Nazionale Tumori, Fondazione IRCCS, University of Milan, Milan, Italy.

Ugo Boggi (U)

Chirurgia Generale Universitaria dell'Ospedale di Cisanello, Via Paradisa, 2, 56124, Pisa, Italy.

Alessandro Zerbi (A)

Humanitas Clinical and Research Center-IRCCS, Rozzano, MI, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.

Roberto Salvia (R)

Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.

Massimo Falconi (M)

Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Sergio Alfieri (S)

Department of Surgery, Gemelli Pancreatic Center, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
CRMPG (Advanced Pancreatic Research Center), Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

Recherchemedicale.com › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Quantitative assessment of the impact of...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Pratiques en santé publique › Contrôle des maladies transmissibles › Quantitative assessment of the impact of...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Quantitative assessment of the impact of...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › Quantitative assessment of the impact of...
Recherchemedicale.com › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › Quantitative assessment of the impact of...
Recherchemedicale.com › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Centres de soins tertiaires › Quantitative assessment of the impact of...