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COVID-19: Impact on Surgery
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COVID-19: Impact on Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (25 June 2022) | Viewed by 8824

Special Issue Editor

Dr. Francesco Pata

E-Mail Website
Guest Editor
1. Department of General Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
2. La Sapienza University, Rome, Italy
Interests: surgery; global surgery; colorectal surgery; surgical site infections (SSIs); COVID-19; stoma care; pruritus ani; haemorrhoids; appendicitis

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has brought about a great challenge in the field of surgery. Most elective activities have been cancelled or postponed, creating a backlog that has increased the burden for surgical services worldwide.

The need of preserving ICU facilities and hospital beds for the overwhelming number of COVID-19 patients has reduced oncological surgical activities, resulting in suboptimal treatments and the late management of potentially curable disease. The nonoperative management (NOM) of surgical emergencies has been implemented, but the overall effect still needs to be elucidated. Perioperative coronavirus infection seems to increase mortality and complications, but more granular data are needed to quantify the impact and identify the best practice to increase patient safety. The implementation of telemedicine and consultations by remote reduced the number of in-person visits, but it poses new challenges for health systems worldwide.

Therefore, researchers in the field of surgery (general surgery and other surgical specialties), interested in analyzing the impact and the consequences of the COVID-19 pandemic on surgery (e.g., surgical services, surgical diseases, surgical patients and surgical training) are encouraged to submit an original article or a review to this Special Issue (case reports and short reviews are not accepted).

Dr. Francesco Pata
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • surgery
  • colorectal
  • COVID-19
  • SARS-CoV-2
  • gastrointestinal
  • coronavirus
  • outbreak
  • pandemic
  • general surgery

Published Papers (5 papers)

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Research

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9 pages, 7382 KiB  
Article
Impact of the COVID-19 Pandemic on Urologic Oncology Surgery: Implications for Moving Forward
by Rossella Guerrieri, Lucrezia Rovati, Paolo Dell’Oglio, Antonio Galfano, Luca Ragazzoni and Paolo Aseni
J. Clin. Med. 2022, 11(1), 171; https://doi.org/10.3390/jcm11010171 - 29 Dec 2021
Cited by 8 | Viewed by 1541
Abstract
The COVID-19 pandemic has caused the destruction of routine hospital services globally, leading to an increase in the backlog of elective surgery cases. The aim of the study was to retrospectively investigate the pandemic’s impact on the urologic oncology surgical activity of a [...] Read more.
The COVID-19 pandemic has caused the destruction of routine hospital services globally, leading to an increase in the backlog of elective surgery cases. The aim of the study was to retrospectively investigate the pandemic’s impact on the urologic oncology surgical activity of a high-volume center located in Milan, Italy. The number and type of procedures performed in 2020 during the COVID-19 pandemic was evaluated using 2019 data as control. Waiting times for each surgical procedure were compared, on a bimonthly basis, between the two different years. Overall, a 26.7% reduction in the number of urologic oncology surgeries between 2019 and 2020 was observed (2019: 720, 2020: 528). Both the main indication for surgery and the type of procedure performed significantly differed between 2019 and 2020 (all p < 0.0001), with a decrease in the number of radical prostatectomies and an increase in the number of radical cystectomies and radical nephrectomies/nephroureterectomies performed in 2020. Waiting time decreased by 20% between 2019 and 2020, with the most significant reduction seen after the first wave of the COVID-19 pandemic (July–October 2020), in particular for partial nephrectomy and radical prostatectomy, possibly due to the underdiagnosis of cases. In conclusion, in accordance with recommendations by international urological societies on prioritization strategies for oncological procedures, a higher proportion of surgeries for high-risk tumors was performed in 2020 at our center at the expense of procedures for lower risk diseases; however, future implications for patients’ prognosis still need to be determined. Full article
(This article belongs to the Special Issue COVID-19: Impact on Surgery)
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11 pages, 904 KiB  
Article
The Adverse Impact of the COVID-19 Pandemic on Abdominal Emergencies: A Retrospective Clinico-Pathological Analysis
by Elena Vissio, Enrico Costantino Falco, Gitana Scozzari, Antonio Scarmozzino, Do An Andrea Trinh, Mario Morino, Mauro Papotti, Luca Bertero and Paola Cassoni
J. Clin. Med. 2021, 10(22), 5254; https://doi.org/10.3390/jcm10225254 - 11 Nov 2021
Cited by 8 | Viewed by 1366
Abstract
The COVID-19 pandemic has caused a worldwide significant drop of admissions to the emergency department (ED). The aim of the study was to retrospectively investigate the pandemic impact on ED admissions, management, and severity of three abdominal emergencies (appendicitis, diverticulitis, and cholecystitis) during [...] Read more.
The COVID-19 pandemic has caused a worldwide significant drop of admissions to the emergency department (ED). The aim of the study was to retrospectively investigate the pandemic impact on ED admissions, management, and severity of three abdominal emergencies (appendicitis, diverticulitis, and cholecystitis) during the COVID-19 pandemic using 2017–2019 data as a control. The difference in clinical and pathological disease severity was the primary outcome measure while differences in (i) ED admissions, (ii) triage urgency codes, and (iii) surgical rates were the second ones. Overall, ED admissions for the selected conditions decreased by 34.9% during the pandemic (control: 996, 2020: 648) and lower triage urgency codes were assigned for cholecystitis (control: 170/556, 2020: 66/356, p < 0.001) and appendicitis (control: 40/178, 2020: 21/157, p = 0.031). Less surgical procedures were performed in 2020 (control: 447, 2020: 309), but the surgical rate was stable (47.7% in 2020 vs. 44.8% in 2017–2019). Considering the clinical and pathological assessments, a higher percentage of severe cases was observed in the four pandemic peak months of 2020 (control: 98/192, 2020: 87/109; p < 0.001 and control: 105/192, 2020: 87/109; p < 0.001). For the first time in this study, pathological findings objectively demonstrated an increased disease severity of the analyzed conditions during the early COVID-19 pandemic. Full article
(This article belongs to the Special Issue COVID-19: Impact on Surgery)
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13 pages, 694 KiB  
Article
Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus
by Tomasz Dziodzio, Sebastian Knitter, Helen Hairun Wu, Paul Viktor Ritschl, Karl-Herbert Hillebrandt, Maximilian Jara, Andrzej Juraszek, Robert Öllinger, Johann Pratschke, Jens Rückert and Jens Neudecker
J. Clin. Med. 2021, 10(13), 2769; https://doi.org/10.3390/jcm10132769 - 24 Jun 2021
Cited by 3 | Viewed by 1735
Abstract
The COVID-19 pandemic challenges international and national healthcare systems. In the field of thoracic surgery, procedures may be deferred due to mandatory constraints of the access to diagnostics, staff and follow-up facilities. There is a lack of prospective data on the management of [...] Read more.
The COVID-19 pandemic challenges international and national healthcare systems. In the field of thoracic surgery, procedures may be deferred due to mandatory constraints of the access to diagnostics, staff and follow-up facilities. There is a lack of prospective data on the management of benign and malignant thoracic conditions in the pandemic. Therefore, we derived recommendations from 14 thoracic societies to address key questions on the topic of COVID-19 in the field of thoracic surgery. Respective recommendations were extracted and the degree of consensus among different organizations was calculated. A high degree of consensus was found to temporarily suspend non-critical elective procedures or procedures for benign conditions and to prioritize patients with symptomatic or advanced cancer. Prior to hospitalization, patients should be screened for respiratory symptoms indicating possible COVID-19 infection and most societies recommended to screen all patients for COVID-19 prior to admission. There was a weak consensus on the usage of serology tests and CT scans for COVID-19 diagnostics. Nearly all societies suggested to postpone elective procedures in patients with suspected or confirmed COVID-19 and recommended constant reevaluation of these patients. Additionally, we summarized recommendations focusing on precautions in the theater and the management of chest drains. This study provides a novel approach to informed guidance for thoracic surgeons during the COVID-19 pandemic in the absence of scientific evidence-based data. Full article
(This article belongs to the Special Issue COVID-19: Impact on Surgery)
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Review

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14 pages, 501 KiB  
Review
Challenges in Burn Care during the COVID-19 Pandemic—A Scoping Review
by Michael Kohlhauser, Hanna Luze, Sebastian Philipp Nischwitz and Lars-Peter Kamolz
J. Clin. Med. 2022, 11(12), 3410; https://doi.org/10.3390/jcm11123410 - 14 Jun 2022
Viewed by 1413
Abstract
Objective: The aim of this review is to map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, in order to enable future strategies with regard to the most effective measures in burn care during pandemics and to detect [...] Read more.
Objective: The aim of this review is to map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, in order to enable future strategies with regard to the most effective measures in burn care during pandemics and to detect possible gaps in knowledge. Background: The coronavirus disease 2019 (COVID-19) pandemic had a major impact on economies, social interactions, and health systems worldwide. Burn units all over the world face a new challenge in maintaining the care of acute burn wounds and follow-up treatments while dealing with constantly changing regulations. Infrastructural changes, the establishment of efficient triage systems, protective measures, personnel resources, in addition to the maintenance of efficient patient care and the guarantee of supply chains, are challenging tasks to be addressed. This review provides an overview of recent developments regarding different strategies and methods used by burn units worldwide to safely overcome the COVID-19 pandemic outbreak. Methods: A scoping review of the literature was conducted using the electronic databases PubMed and Google Scholar. Publications were screened for the following key terms: burns, burn injuries, thermal injuries, burn center, burn unit, burn ward, in combination with COVID-19, COVID-19 pandemic, SARS-CoV-2, Corona, and Coronavirus. Articles dealing with the management of burn units during the pandemic were further analyzed and included. Results: Of the 136 publications, 10 were considered relevant to the key question and were included in the present review. Results were divided into six major topics, such as infrastructural and personnel management, triaging, severe burns and emergencies, elective surgeries, patient and visitor management, and outpatient management. Conclusion: Only a few studies about managing burn units during the COVID-19 pandemic have been published. Personnel resources and equipment needed to be redistributed to cope with country-specific challenges during the COVID-19 pandemic and to maintain adequate burn care. Since all of these articles refer to the period of the initial outbreak, a lack of clinical studies exists regarding the prevention measures taken by burn units during the COVID-19 pandemic. In addition, we identified gaps in knowledge about the impact of implemented measures on burn patient outcomes in the published literature. Further studies are mandatory in order to provide generally applicable guidelines regarding COVID-19 prevention measures at a burn unit. Full article
(This article belongs to the Special Issue COVID-19: Impact on Surgery)
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18 pages, 1322 KiB  
Review
Robotic Abdominal Surgery and COVID-19: A Systematic Review of Published Literature and Peer-Reviewed Guidelines during the SARS-CoV-2 Pandemic
by Christina A. Fleming, Anna Fullard, Stefanie Croghan, Gianluca Pellino and Francesco Pata
J. Clin. Med. 2022, 11(11), 2957; https://doi.org/10.3390/jcm11112957 - 24 May 2022
Cited by 3 | Viewed by 1899
Abstract
Background: Significant concern emerged at the beginning of the SARS-CoV-2 pandemic regarding the safety and practicality of robotic-assisted surgery (RAS). We aimed to review reported surgical practice and peer-reviewed published review recommendations and guidelines relating to RAS during the pandemic. Methods: A systematic [...] Read more.
Background: Significant concern emerged at the beginning of the SARS-CoV-2 pandemic regarding the safety and practicality of robotic-assisted surgery (RAS). We aimed to review reported surgical practice and peer-reviewed published review recommendations and guidelines relating to RAS during the pandemic. Methods: A systematic review was performed in keeping with PRISMA guidelines. This study was registered on Open Science Framework. Databases were searched using the following search terms: ‘robotic surgery’, ‘robotics’, ‘COVID-19’, and ‘SARS-CoV-2’. Firstly, articles describing any outcome from or reference to robotic surgery during the COVID-19/SARS-CoV-2 pandemic were considered for inclusion. Guidelines or review articles that outlined recommendations were included if published in a peer-reviewed journal and incorporating direct reference to RAS practice during the pandemic. The ROBINS-I (Risk of Bias in Non-Randomised Studies of Intervention) tool was used to assess the quality of surgical practice articles and guidelines and recommendation publications were assessed using the AGREE-II reporting tool. Publication trends, median time from submission to acceptance were reported along with clinical outcomes and practice recommendations. Results: Twenty-nine articles were included: 15 reporting RAS practice and 14 comprising peer-reviewed guidelines or review recommendations related to RAS during the pandemic, with multiple specialities (i.e., urology, colorectal, digestive surgery, and general minimally invasive surgery) covered. Included articles were published April 2020—December 2021, and the median interval from first submission to acceptance was 92 days. All surgical practice studies scored ‘low’ or ‘moderate’ risk of bias on the ROBINS-I assessment. All guidelines and recommendations scored ‘moderately well’ on the AGREE-II assessment; however, all underperformed in the domain of public and patient involvement. Overall, there were no increases in perioperative complication rates or mortalities in patients who underwent RAS compared to that expected in non-COVID practice. RAS was deemed safe, with recommendations for mitigation of risk of viral transmission. Conclusions: Continuation of RAS was feasible and safe during the SARS-CoV-2 pandemic where resources permitted. Post-pandemic reflections upon published robotic data and publication patterns allows us to better prepare for future events and to enhance urgent guideline design processes. Full article
(This article belongs to the Special Issue COVID-19: Impact on Surgery)
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