Surgical management protocol during the COVID-19 pandemic in an Italian non-referral center.

Balla, Andrea; De Carlo, Antonio; Aguzzi, Daniele; Petrocca, Sergio; Guida, Anna; Saraceno, Federica; Scaramuzzo, Rosa; Fanello, Gianfranco; Borrello, Alessandro; Ferranti, Fabrizio; Lepiane, Pasquale

BACKGROUND In the surgical scenario, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diffusion worldwide entails on one end the need to continue to perform surgery at least in case of emergency or oncologic surgery, in patients with or without COrona Virus Disease 2019 (COVID-19), and on the other hand, to avoid the pandemic diffusion both between patients and medical and nursing team. Aim is to report our surgical management protocol during the COVID-19 pandemic in an Italian non-referral center. METHODS Data retrieved during the outbreak for the COVID-19 pandemic, from March 8 to May 4, 2020 (study period) were analyzed and compared to data obtained during the same period in 2019 (control period). RESULTS During the study period 41 surgical procedures (24 electives, 17 emergency surgical procedures) underwent surgery in comparison to 99 procedures in the control period. Stratified procedures in elective and emergency surgery, and based on the indication for surgery, the only statistically significant difference was observed in the elective surgery regarding the abdominal wall surgery (0 vs. 13 procedures, p=0.0339). Statistically significant differences were not observed regarding the colorectal and the breast oncologic surgery. All stuff members were COVID-19 free. CONCLUSIONS The present protocol proved to be safe and useful to prevent SARS-CoV-2 infection before and after surgery for both patients and stuff. The pandemic was responsible for the reduction in number of procedures performed, anyway for the oncologic surgery a statistically significant volume reduction in comparison to 2019 was not observed.