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Georgiou M, Ridzuan-Allen A, Chamsin A, Siddiqui Z, Tolofari S, Ejikeme C, Jones R, Napier-Hemy TP, Rotas S, Hughes KE, Khattak AQ, McCabe JE, Omar AM, Mistry R, Samsudin A, Gana HBY, Floyd MS. Emergency Urology procedures during the COVID-19 pandemic in the UK: A 3-month prospective study. Urologia 2023; 90:407-414. [PMID: 36346172 PMCID: PMC9646888 DOI: 10.1177/03915603221136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency surgical care. Specific to Merseyside, Tier 4, Tier 2 and Tier 5 restrictions were introduced in late 2020 and early 2021. The purpose of this study was to examine the nature and workload of emergency urological procedures during three different national lockdown Tiers in the North West of England. METHOD A 3-month prospective study examining all emergency urological activity was conducted from November 2020 when Tier 4 restrictions were introduced and included Tier 2 restrictions in December and then concluded at the end of January 2021 when Tier 5 restrictions were in place. Data was obtained by identifying patients using the electronic theatre listing system. RESULTS A total of 71 emergency cases were performed (24 in November (Tier 4), 28 in December (Tier 2), 19 in January 2021 (Tier 5)) with 15 different types of procedures performed. The most frequently performed procedure was stent insertion (36), followed by scrotal exploration (10). The least commonly performed procedure was suprapubic catheter insertion under general anaesthesia (1). One patient required transfer to a different hospital. In total 6 calls were made by general surgery and 3 by gynaecology for urgent urological assistance in theatre. Three urology patients returned to the theatre as emergencies following elective procedures. CONCLUSION Unlike the Spring lockdown, acute urological presentations requiring operative intervention still presented daily. Of the 71 cases performed, most occurred in Tier 2. Stent insertion was the most commonly performed procedure, with the majority of the cases performed by registrars.
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Affiliation(s)
- Marita Georgiou
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Adam Ridzuan-Allen
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Alaa Chamsin
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Zain Siddiqui
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Sotonye Tolofari
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Chidozie Ejikeme
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Richard Jones
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Timothy P Napier-Hemy
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Stefanos Rotas
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Kaylie E Hughes
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Altaf Q Khattak
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - John E McCabe
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Ahmad M Omar
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Rahul Mistry
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Azizan Samsudin
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Hosea BY Gana
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
| | - Michael S Floyd
- Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK
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Di Cosimo S, Susca N, Apolone G, Silvestris N, Racanelli V. The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic. Front Oncol 2022; 12:961380. [PMID: 36249038 PMCID: PMC9556993 DOI: 10.3389/fonc.2022.961380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/12/2022] [Indexed: 01/19/2023] Open
Abstract
Background The rapid and global spread of COVID-19 posed a massive challenge to healthcare systems, which came across the need to provide high-intensity assistance to thousands of patients suffering from SARS-CoV-2 infection while assuring continuous care for all other diseases. This has been of particular importance in the oncology field. This study explores how oncology centers responded to the pandemic at a single center level by assessing surveys addressing different aspects of cancer care after the pandemic outbreak. Methods We performed a systematic review and meta-analysis of the cancer care surveys published until December 11th, 2020. Data were analyzed according to three main areas of interest, namely health care organization, including cancellation/delay and/or modification of scheduled treatments, cancellation/delay of outpatient visits, and reduction of overall cancer care activities; routine use of preventive measures, such as personal protective equipment (PPE) by both patients and health care workers, and systematic SARS-CoV-2 screening by nasopharyngeal swabs; and implementation of telemedicine through remote consultations. Findings Fifty surveys reporting data on 9150 providers from 121 countries on 5 continents were included. Cancellation/delay of treatment occurred in 58% of centers; delay of outpatient visits in 75%; changes in treatment plans in 65%; and a general reduction in clinical activity in 58%. Routine use of PPE by patients and healthcare personnel was reported by 81% and 80% of centers, respectively; systematic SARS-CoV-2 screening by nasopharyngeal swabs was reported by only 41% of centers. Virtual visits were implemented by the majority (72%) of centers. Interpretation These results describe the negative impact of COVID-19 on cancer care, the rapid response of cancer centers in terms of preventive measures and alternative treatment approaches such as telemedicine, and confirm that surveys can provide the valuable, low-cost and immediate information that critical situations require.
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Affiliation(s)
- Serena Di Cosimo
- Platform of Integrated Biology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Susca
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Vito Racanelli
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
- *Correspondence: Vito Racanelli,
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