Deadlock of proctologic practice in Italy during COVID-19 pandemic: a national report from ProctoLock2020

Abstract

Proctology is one of the surgical specialties that suffered the most during COVID-19 pandemic. Using data from a crosssectional worldwide web survey, we aimed to snapshot the current status of proctologic practice in Italy with differences between three macro areas (North, Centre, South). Specialists affiliated to renowned scientific societies with an interest in coloproctology were invited to join a 27-item survey. Predictive power of respondents' and hospitals' demographics on the change of status of surgical activities was calculated. The study was registered at ClinicalTrials.gov (NCT 04392245). Of 299 respondents from Italy, 94 (40%) practiced in the North, 60 (25%) in the Centrer and 82 (35%) in the South and Islands. The majority were men (79%), at consultant level (70%), with a mean age of 46.5 years, practicing in academic hospitals (39%), where a dedicated proctologist was readily available (68%). Southern respondents were more at risk of infection compared to those from the Center (OR, 3.30; 95%CI 1.46; 7.47, P = 0.004), as were males (OR, 2.64; 95%CI 1.09; 6.37, P = 0.031) and those who routinely tested patients prior to surgery (OR, 3.02; 95%CI 1.39; 6.53, P = 0.005). The likelihood of ongoing surgical practice was higher in the South (OR 1.36, 95%CI 0.75; 2.46, P = 0.304) and in centers that were not fully dedicated to COVID-19 care (OR 4.00, 95%CI 1.88; 8.50, P < 0.001). The results of this survey highlight important factors contributing to the deadlock of proctologic practice in Italy and may inform the development of future management strategies.

Sclerotherapy with 3% polidocanol foam: revolutionizing outpatient treatment in patients with haemorrhoidal disease

“…In particular, proctology was one of the most affected surgical specialties during the COVID-19 outbreak [ 2 ]. In fact, according to a recent worldwide survey including 1050 experts and aimed to evaluate the status of proctological practice, elective oncological and non-oncological surgery, emergency surgery and outpatient practice were reduced or fully stopped with an increased likelihood of delayed anorectal cancer.…”

Proctologic Surgery Prioritization After the Lockdown: Development of a Scoring System

“…Elective surgery for benign conditions faced a cancelation of procedures to an estimate of 71.2-87.4% (2). The practice of surgical coloproctology was heavily affected by this lockdown, since most operations performed in this area were for benign, functional disorders (4)(5)(6).…”

“…Elective operations for coloproctological diseases suffered noticeably since they had been completely canceled at the time of the lockdown (4)(5)(6). Delayed surgery even for benign or functional disease may result in complications, unplanned emergency surgery, deterioration of individual health, disability, and social costs (7,8).…”

Results of sclerotherapy and mucopexy with haemorrhoidal dearterialization in II and III degree haemorrhoids. A 4 years' single centre experience

“…A retrospective study was designed to evaluate the safety, efficacy and long-term outcomes of sclerotherapy and mucopexy with non-Doppler guided haemorrhoidal dearterialization for symptomatic haemorrhoidal disease. The study was carried out in the Coloproctology Unit “Bari 2”, Hospital University of Bari, between February 2018 and December 2021 (including the first wave of the Sars-Cov-2 pandemic, when there was a decrease in surgical activities ( 7 , 8 ). All patients were not enrolled consecutively and all procedures were performed by the same experienced surgeon.…”