Deadlock of proctologic practice in Italy during COVID-19 pandemic: a national report from ProctoLock2020

Gaetano Gallo, Alessandro Sturiale, Veronica De Simone, Stefano Mancini, Gian Luca Di Tanna, Giovanni Milito, Francesco Bianco, Roberto Perinotti, Iacopo Giani, Ugo Grossi, ProctoLock2020 Working Group, Domenico Aiello, Francesco Bianco, Andrea Bondurri, Gaetano Gallo, Marco La Torre, Giovanni Milito, Roberto Perinotti, Renato Pietroletti, Alberto Serventi, Marina Fiorino, Veronica De Simone, Ugo Grossi, Michele Manigrasso, Alessandro Sturiale, Gloria Zaffaroni, Ferruccio Boffi, Vittoria Bellato, Francesco Cantarella, Simona Deidda, Fabio Marino, Jacopo Martellucci, Marco Milone, Arcangelo Picciariello, Ana Minaya Bravo, Vincenzo Vigorita, Miguel Fernandes Cunha, Sezai Leventoglu, Tatiana Garmanova, Petr Tsarkov, Alaa El-Hussuna, Alice Frontali, Argyrios Ioannidis, Gabriele Bislenghi, Mostafa Shalaby, Felipe Celedon Porzio, Jiong Wu, David Zimmerman, Claudio Elbetti, Julio Mayol, Gabriele Naldini, Mario Trompetto, Giuseppe Sammarco, Giulio Aniello Santoro, Gaetano Gallo, Alessandro Sturiale, Veronica De Simone, Stefano Mancini, Gian Luca Di Tanna, Giovanni Milito, Francesco Bianco, Roberto Perinotti, Iacopo Giani, Ugo Grossi, ProctoLock2020 Working Group, Domenico Aiello, Francesco Bianco, Andrea Bondurri, Gaetano Gallo, Marco La Torre, Giovanni Milito, Roberto Perinotti, Renato Pietroletti, Alberto Serventi, Marina Fiorino, Veronica De Simone, Ugo Grossi, Michele Manigrasso, Alessandro Sturiale, Gloria Zaffaroni, Ferruccio Boffi, Vittoria Bellato, Francesco Cantarella, Simona Deidda, Fabio Marino, Jacopo Martellucci, Marco Milone, Arcangelo Picciariello, Ana Minaya Bravo, Vincenzo Vigorita, Miguel Fernandes Cunha, Sezai Leventoglu, Tatiana Garmanova, Petr Tsarkov, Alaa El-Hussuna, Alice Frontali, Argyrios Ioannidis, Gabriele Bislenghi, Mostafa Shalaby, Felipe Celedon Porzio, Jiong Wu, David Zimmerman, Claudio Elbetti, Julio Mayol, Gabriele Naldini, Mario Trompetto, Giuseppe Sammarco, Giulio Aniello Santoro

Abstract

Proctology is one of the surgical specialties that suffered the most during COVID-19 pandemic. Using data from a cross-sectional worldwide web survey, we aimed to snapshot the current status of proctologic practice in Italy with differences between three macro areas (North, Centre, South). Specialists affiliated to renowned scientific societies with an interest in coloproctology were invited to join a 27-item survey. Predictive power of respondents' and hospitals' demographics on the change of status of surgical activities was calculated. The study was registered at ClinicalTrials.gov (NCT04392245). Of 299 respondents from Italy, 94 (40%) practiced in the North, 60 (25%) in the Centrer and 82 (35%) in the South and Islands. The majority were men (79%), at consultant level (70%), with a mean age of 46.5 years, practicing in academic hospitals (39%), where a dedicated proctologist was readily available (68%). Southern respondents were more at risk of infection compared to those from the Center (OR, 3.30; 95%CI 1.46; 7.47, P = 0.004), as were males (OR, 2.64; 95%CI 1.09; 6.37, P = 0.031) and those who routinely tested patients prior to surgery (OR, 3.02; 95%CI 1.39; 6.53, P = 0.005). The likelihood of ongoing surgical practice was higher in the South (OR 1.36, 95%CI 0.75; 2.46, P = 0.304) and in centers that were not fully dedicated to COVID-19 care (OR 4.00, 95%CI 1.88; 8.50, P < 0.001). The results of this survey highlight important factors contributing to the deadlock of proctologic practice in Italy and may inform the development of future management strategies.

Keywords: COVID-19; Italy; Lockdown; ProctoLock2020; Proctology; SARS-COV-2.

Conflict of interest statement

All authors declare no personal conflict of interest.

Figures

Fig. 1
Fig. 1
Current status of proctologic surgical practice in Italy and rest of Europe. Light to dark color scale represents a low to high prevalence of respondents across countries

References

    1. Caricato M, Baiocchi GL, Crafa F, et al. Colorectal surgery in Italy during the Covid19 outbreak: a survey from the iCral study group [published online ahead of print, 2020 May 20] Updates Surg. 2020 doi: 10.1007/s13304-020-00760-3.
    1. CovidSurg Collaborative. Nepogodiev D, Bhangu A. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans [published online ahead of print, 2020 May 12] Br J Surg. 2020 doi: 10.1002/bjs.11746.
    1. Giani I, Elbetti C, Trompetto M, Gallo G. Proctology in the COVID-19 era: handle with care [published online ahead of print, 2020 May 15] Br J Surg. 2020 doi: 10.1002/bjs.11676.
    1. Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831–1833.e3. doi: 10.1053/j.gastro.2020.02.055.
    1. Gallo G, La Torre M, Pietroletti R, et al. Italian society of colorectal surgery recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic. Tech Coloproctol. 2020;24(6):501–505. doi: 10.1007/s10151-020-02209-6.
    1. COVIDSurg Collaborative Global guidance for surgical care during the COVID-19 pandemic [published online ahead of print, 2020 Apr 15] Br J Surg. 2020 doi: 10.1002/bjs.11646.
    1. Di Saverio S, Pata F, Gallo G, et al. Coronavirus pandemic and Colorectal surgery: practical advice based on the Italian experience. Colorectal Dis. 2020 doi: 10.1111/codi.15056.
    1. Felice C, Di Tanna GL, Zanus G, Grossi U. Impact of COVID-19 outbreak on healthcare workers in Italy: results from a National E-Survey [published online ahead of print, 2020 May 22] J Community Health. 2020 doi: 10.1007/s10900-020-00845-5.
    1. . Accessed July 1st 2020
    1. Ratto C, Grossi U, Litta F, et al. Contemporary surgical practice in the management of anal fistula: results from an international survey. Tech Coloproctol. 2019;23(8):729–741. doi: 10.1007/s10151-019-02051-5.
    1. Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) [published correction appears in doi:10.2196/jmir.2042] J Med Internet Res. 2004;6(3):e34. doi: 10.2196/jmir.6.3.e34.
    1. Carinci F. Covid-19: preparedness, decentralisation, and the hunt for patient zero. BMJ. 2020;368:bmj.m799. doi: 10.1136/bmj.m799.
    1. . Accessed 7 April 2020
    1. Hindson J. COVID-19: faecal-oral transmission? Nat Rev Gastroenterol Hepatol. 2020;17(5):259. doi: 10.1038/s41575-020-0295-7.
    1. Bianco F, Incollingo P, Grossi U, Gallo G. Preventing transmission among operating room staff during COVID-19 pandemic: the role of the Aerosol Box and other personal protective equipment. Updates Surg. 2020 doi: 10.1007/s13304-020-00818-2.
    1. Giulio M, Maggioni D, Montroni I, et al. Being a doctor will never be the same after the COVID-19 pandemic. Am J Med. 2020;S0002–9343(20):30216–30223. doi: 10.1016/j.amjmed.2020.03.003.
    1. Ives J, Huxtable R. Surgical Ethics During a Pandemic: Moving into the Unknown? [published online ahead of print, 2020 Mar 30] Br J Surg. 2020 doi: 10.1002/bjs.11638.
    1. Bryan AF, Milner R, Roggin KK, Angelos P, Matthews JB. Unknown unknowns: surgical consent during the COVID-19 pandemic [published online ahead of print, 2020 Apr 29] Ann Surg. 2020 doi: 10.1097/SLA.0000000000003995.
    1. de Leo D, Trabucchi M. COVID-19 and the fears of Italian senior citizens. Int J Environ Res Public Health. 2020;17(10):E3572. doi: 10.3390/ijerph17103572.
    1. Pellino G, Spinelli A. How COVID-19 outbreak is impacting colorectal cancer patients in Italy: a long shadow beyond infection [published online ahead of print, 2020 Mar 17] Dis Colon Rectum. 2020 doi: 10.1097/DCR.0000000000001685.
    1. Elbetti C, Caminati F, Giani I, et al. Tailored anal block (TAB): a new anesthesia procedure for surgical treatment of hemorrhoids in an outpatient setting. Tech Coloproctol. 2019;23(5):497–500. doi: 10.1007/s10151-019-01998-9.
    1. Gallo G, Sturiale A, De Simone V, et al. The impact of COVID-19 on proctologic practice in Italy. Tech Coloproctol. 2020 doi: 10.1007/s10151-020-02319-1.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir