Upper gastrointestinal stenting during the SARS-CoV-2 outbreak: impact of mitigation measures and risk of contamination for patients and staff

Abstract

Background and study aims The impact of COVID-19 mitigation measures on stent placement procedures has not yet been reported. The aim of this study was to assess the impact of COVID-19 mitigation measures on upper stenting during SARS-CoV-2 outbreak, as well as the use of personal protection equipment (PPE) and risk of contamination for patients and staff. Patients and methods This was a multicenter, retrospective study of consecutive patients who underwent stent placement for upper gastrointestinal obstruction during the second half of SARS-CoV-2 outbreak period in comparison to same period one year before. Results A total of 29 stents were placed for upper gastrointestinal obstruction during the study period, corresponding to an increase of 241 % comparing to the same period in 2019 (n = 12). No significant major differences were found between the two time periods regarding patients’ baseline characteristics, post-stenting management and number of staff involved in stent placement. Fellows’ involvement was significantly lower in 2020 compared to 2019 (21 % vs 67 %; P = 0.01). The majority of procedures were performed using FFP2 /FFP3 mask (76 %), protective eyewear (86 %), two pairs of gloves (65 %), hairnet (76 %) and full disposable gowns (90 %). One patient tested positive for SARS-CoV-2 after the procedure. None of the medical staff involved in stenting procedures developed COVID-19 14 days after procedure. Conclusion Upper gastrointestinal stenting increased during the SARS-CoV-2 outbreak period, which could be related to yearly variation on the number of procedures or reflect a change of oncologic treatment practice during COVID times.

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

“…Concerning surgeries and loco-regional therapies, 106 indicators were identified from 30 articles [42,48–51,55,62,65,65,75,81,90,92–94,97–99,101–103,111,118–125]. Of those, 82 indicators (79%) showed a reduction in the number of treatment procedures, namely in Italy, France, Germany, Ireland, Netherlands, Spain, Turkey, UK, US, Australia, and in 1 international study.…”

“…Regarding "delay in treatment", a total of 42 indicators from 18 articles [39,52,72,77,81,89,91,92,96,97,99,101,138,[142][143][144][145][146] were identified. Of those, 18 (43%) reported an increasing trend in waiting time to treatment, namely in France, Portugal, Canada, US, and Italy.…”

“…A total of 12 indicators from 4 articles [42,55,93,99] reported on the "number of visits and admissions" of cancer patients to the hospital. Of these indicators, 10 (83%) signalled a decreasing trend.…”

“…Two main outcomes were addressed in the included articles: "procedures and surgical outcome measures" and "mortality". Fifteen indicators from 8 articles [93,[97][98][99][100][101][102][103] conveyed information regarding procedures' outcomes. From these indicators, 11 (73%) showed similar complication rates.…”

“…The indicators that reported on "changes in cancer staging" were grouped in 3 different categories: general staging indicators (14 indicators from 8 articles[75,77,81,[94][95][96][97][98]), proportion of earliest-stage cancers (35 indicators from 9 articles[41,71,81,[99][100][101][102][103][104]), and proportion of advanced-stage cancers (61 indicators from 17 articles[39,57,63,66,77,79,87,92,93,[95][96][97][98][99][100][101][102]). Most of the general staging indicators (n=9, 64%) showed stability in cancer stages distribution at diagnosis, when comparing the pre-and post-lockdown periods (data from Italy, US, UK, France, US, and Portugal).…”