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Minervini A, Di Maida F, Mari A, Porreca A, Rocco B, Celia A, Bove P, Umari P, Volpe A, Galfano A, Pastore AL, Annino F, Parma P, Greco F, Nucciotti R, Schiavina R, Esposito F, Romagnoli D, Leonardo C, Falabella R, Gallo F, Amenta M, Sciorio C, Verze P, Tafuri A, Pucci L, Varca V, Zaramella S, Pagliarulo V, Bozzini G, Ceruti C, Falsaperla M, Cafarelli A, Antonelli A. Perioperative outcomes of patients undergoing urological elective surgery during the COVID-19 pandemic: a national overview across 28 Italian institutions. Cent European J Urol 2021; 74:259-268. [PMID: 34336248 PMCID: PMC8318031 DOI: 10.5173/ceju.2021.0374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/02/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction The aim of this study was to assess the safety of elective urological surgery performed during the pandemic by estimating the prevalence of COVID-19-like symptoms in the postoperative period and its correlation with perioperative and clinical factors. Material and methods In this multicenter, observational study we recorded clinical, surgical and postoperative data of consecutive patients undergoing elective urological surgery in 28 different institutions across Italy during initial stage of the COVID-19 pandemic (between February 24 and March 30, 2020, inclusive). Results A total of 1943 patients were enrolled. In 12%, 7.1%, 21.3%, 56.7% and 2.6% of cases an open, laparoscopic, robotic, endoscopic or percutaneous surgical approach was performed, respectively. Overall, 166 (8.5%) postoperative complications were registered, 77 (3.9%) surgical and 89 (4.6%) medical. Twenty-eight (1.4%) patients were readmitted to hospital after discharge and 13 (0.7%) died. In the 30 days following discharge, fever and respiratory symptoms were recorded in 101 (5.2%) and 60 (3.1%) patients. At multivariable analysis, not performing nasopharyngeal swab at hospital admission (HR 2.3; CI 95% 1.01–5.19; p = 0.04) was independently associated with risk of developing postoperative medical complications. Number of patients in the facility was confirmed as an independent predictor of experiencing postoperative respiratory symptoms (p = 0.047, HR:1.12; CI95% 1.00–1.05), while COVID-19-free type of hospitalization facility was a strong independent protective factor (p = 0.02, HR:0.23, CI95% 0.07–0.79). Conclusions Performing elective surgery during the COVID-19 pandemic does not seem to affect perioperative outcomes as long as proper preventive measures are adopted, including nasopharyngeal swab before hospital admission and hospitalization in dedicated COVID-19-free facilities.
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Affiliation(s)
- Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Fabrizio Di Maida
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Angelo Porreca
- Department of Oncological Urology - Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy
| | - Bernardo Rocco
- Department of Urology, ASST Santi Paolo e Carlo Dipartimento di Scienze della Salute - Università degli Studi di Milano, Milano, Italy
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Pierluigi Bove
- Department of Urology, San Carlo di Nancy Hospital, Rome, Italy
| | - Paolo Umari
- Division of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Volpe
- Division of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | | | - Antonio Luigi Pastore
- Department of Medical-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome, Urology Unit ICOT, Latina, Italy
| | | | - Paolo Parma
- Urology Department, Ospedale Poma, Mantova, Italy
| | | | | | | | - Fabio Esposito
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Daniele Romagnoli
- Department of Oncological Urology - Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy
| | | | - Roberto Falabella
- Department of Urology, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | - Fabrizio Gallo
- Department of Urology, San Paolo Hospital, Savona, Italy
| | | | | | - Paolo Verze
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alessandro Tafuri
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Italy
| | - Luigi Pucci
- Department of Urology, AORN A. Cardarelli, Naples, Italy
| | - Virginia Varca
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | | | | | - Giorgio Bozzini
- Urology Department, ASST Valle Olona, Busto Arsizio, Varese, Italy
| | - Carlo Ceruti
- SCDU Urologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Italy
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