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?:abstract
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Coronavirus Disease-19 (COVID-19) outbreak has significantly burdened healthcare systems worldwide, leading to reorganization of healthcare services and reallocation of resources The Italian Society for Study of Esophageal Diseases (SISME) conducted a national survey to evaluate changes in esophageal cancer management in a region severely struck by COVID-19 pandemic A web-based questionnaire (26 items) was sent to 12 SISME units Short-term outcomes of esophageal resections performed during the lockdown were compared with those achieved in the same period of 2019 Six (50%) centers had significant restrictions in their activity However, overall number of resections did not decrease compared to 2019, while a higher rate of open esophageal resections was observed (40 vs 21 7%;P = 0 034) Surgery was delayed in 24 (36 9%) patients in 6 (50%) centers, mostly due to shortage of anesthesiologists, and occupation of intensive care unit beds from intubated COVID-19 patients Indications for neoadjuvant chemo (radio) therapy were extended in 14% of patients Separate COVID-19 hospital pathways were active in 11 (91 7%) units COVID-19 screening protocols included nasopharyngeal swab in 91 7%, chest computed tomography scan in 8 3% and selective use of lung ultrasound in 75% of units Postoperative interstitial pneumonia occurred in 1 (1 5%) patient Recovery from COVID-19 pandemic was characterized by screening of patients in all units, and follow-up outpatient visits in only 33% of units This survey shows that clinical strategies differed considerably among the 12 SISME centers Evidence-based guidelines are needed to support the surgical esophageal community and to standardize clinical practice in case of further pandemics
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