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• W4377093820 abstract "COVID-19 is having a worldwide impact on surgical treatment. Our aim was to investigate the impact of the pandemic in a rural hospital serving a low densely populated area.We investigated the volume and type of surgical performed operations during both the pandemic (March 2020 - February 2021) and pre-pandemic periods (March 2019 - February 2020) as well as during the first and second pandemic waves compared to the pre-pandemic period. We compared the volume and timing of emergency appendectomy and cholecystectomy performed during the pandemic with those of the pre-pandemic period, doing the same with the volume, timing and stages of elective gastric and colorectal resections for cancer.In the pre-pandemic period a higher number of appendectomies (42 vs. 24) and urgent and elective cholecystectomies (174 vs. 126) was performed. The patients operated during the pandemic period (both for appendectomy and cholecystectomy) were on average older (58 vs. 52 years old, p=0.006), including for cholecystectomy (73 vs. 66 years old, p=0.01) and appendectomy (43 vs. 30 years old, p =0.04). The logistic regression analysis with regard to the cholecystectomies and appendectomies performed in emergency showed that male sex and age were associated with gangrenous type histology, both in the pandemic and pre-pandemic period. Finally, we found a reduction in the stage I and IIA colorectal cancers operated during the pandemic compared to those of the pre-pandemic period, with no increase of the advanced stages.The reduction in services imposed by governments during the first months of total lock down could not justify the whole decrease in surgical interventions in the year of the pandemic. Data suggest that greater non-operative management for appendicitis and acute cholecystitis does not lead to an increase of cases operated over time, nor to an increase in the gangrenous pattern, this seems to depend on age advanced and male population.COVID-19, Emergency Surgery, General Surgery, Pandemics.La diffusione del COVID-19 sta avendo un impatto mondiale sui trattamenti chirurgici ed attualmente mancano dati pubblicati sulle attività di chirurgia degli ospedali rurali. Il nostro obiettivo è stato indagare l’impatto della pandemia nel contesto di un ospedale rurale, in una zona a bassa densità di popolazione, nel nord Italia. Abbiamo analizzato il volume e il tipo di interventi chirurgici eseguiti nei 12 mesi di pandemia (dal marzo 2020 al febbraio 2021) rispetto al periodo pre-pandemico di medesima durata (dal marzo 2019 al febbraio 2020). Inoltre, abbiamo analizzato i dati della prima e seconda ondata pandemica (intesi come trimestri) rispetto al medesimo periodo pre-pandemico nel 2019. Infine, abbiamo confrontato il numero degli interventi di appendicectomia e colecistectomia durante la pandemia rispetto al periodo pre-pandemico ed il volume e i tempi di attesa degli interventi elettivi per cancro di resezioni gastriche e di colon durante la pandemia rispetto al periodo pre-pandemico. Nel periodo pre-pandemico, rispetto a quello pandemico, sono state eseguite complessivamente 42 appendicectomie contro 24 e 174 colecistectomie contro 126. I pazienti operati nel periodo pre-pandemico erano complessivamente più anziani (58 anni rispetto a 52 anni, p=0,006) e tale dato si manteneva costante anche quando erano distinti i tipi di intervento: colecistectomia (73 contro 66 anni, p=0,01) e appendicectomia (43 contro 30 anni, p =0,04). L’analisi di regressione logistica relativa alla colecistectomia e all’appendicectomia eseguita in emergenza ha mostrato che il sesso maschile e l’età erano entrambi correlati all’istologia di tipo gangrenoso, sia in periodo prepandemico che in quello pandemico. Infine, abbiamo riscontrato una riduzione degli stadi I e IIA per cancro del colon in periodo pandemico rispetto al periodo prepandemico, senza che vi fosse a tutt’oggi un aumento degli stadi più avanzati. CONCLUSIONI: la riduzione dei servizi imposta dai governi nei primi mesi del lock down totale non ha giustificato complessivamente la diminuzione degli interventi chirurgici eseguiti nell’anno della pandemia. I dati suggeriscono che una maggiore “gestione non operatoria” per i casi di appendicite e colecistite acuta non comporti un aumento successivo dei casi operati, né un aumento del pattern istologico “gangrenoso”, che sembra invece dipendere dall’età avanzata e dalla popolazione maschile." @default.
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• W4377093820 date "2023-01-01" @default.
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• W4377093820 title "Long term Implications in Surgical re-Assisting (L.I.S.A. study) during the Covid-19 outbreak. A retrospective observational cohort study on a rural population." @default.
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