Abstract
IntroductionCOVID-19 is a declared worldwide pandemic. In our country, due to shortage of hospitals and beds in intensive care unit, oncological and breast cancer (BC) resources are temporarily shifted to COVID-19 patients. In addition, risk of cross-infections should be considered in these frail patients. To accomplish more surgical procedures and to reduce the length of hospital stay (LOS), fast track awake BC surgery should be implemented. The aim of the study is to estimate the effects of surgical shift in our facility during the early COVID-19 outbreak.Materials and methodsFrom 30th January 2020 to 30th of March 2020, 86 consecutive patients were retrospectively enrolled and divided into pre-COVID-19-BC and COVID-19-BC. Clinical parameters and anamnestic data were collected and analyzed. Surgical procedures, relative complications and type of anaesthesia were reported. The effect on surgical time (ST), operative room time (ORT) and length of stay (LOS) were described and examined.ResultsNo statistical difference was found in complications rate, clinical data and surgical procedures (p > 0.05). Awake breast conservative surgery (BCS) was the most frequent procedure in COVID-19-BC (p = 0.006). A statistically significant decrease in ORT and LOS was reported in COVID-19-BC (p = 0.040 and p = 0.0015 respectively), while comparable time resulted for ST (p = 0.976). Mean ORT and LOS reduction were 20.79 min and 0.57 hospital bed days.ConclusionIn the “COVID-19 era”, fast track awake breast surgery provides a reduction of ORT, LOS and potentially surgical treatment for a wider number of oncological patients.
Highlights
Patients were grouped according to surgical period into pre-COVID-19 and COVID-19 patients. 1st March 2020 was defined as the cut-off, meaning the moment when the first not-imported COVID-19 case was registered in Rome
No statistically significant difference was found in age, body mass index (BMI), family and personal history of breast cancer (BC)
Clinical presentation showed no statistically significant difference, maximum diameter and early breast cancer (EBC) rate was similar between the two groups (p > 0.05)
Summary
To accomplish more surgical procedures and to reduce the length of hospital stay (LOS), fast track awake BC surgery should be implemented. Conclusion In the “COVID-19 era”, fast track awake breast surgery provides a reduction of ORT, LOS and potentially surgical treatment for a wider number of oncological patients. Planned construction of temporary COVID-19 hospitals may be not sufficient to control the epidemic during the highest peak Despite all these measures, rearrangement of operating room into makeshift ICU is progressively taking hold in hospitals [1]. Rearrangement of operating room into makeshift ICU is progressively taking hold in hospitals [1] Due to this reason, Italian College of Anaesthesiologists and several oncologic Chinese scientific committees issued some recommendations to face COVID-19 for prevention, risk reduction and correct usage of resources. A coordinated action of physicians’ scientific committee could be able to reduce COVID-19 infection [2,3,4,5,6,7]
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