Abstract
Objectives: Real-life overview of bladder cancer (BC) surgical management in Italy during the first month of COVID-19 pandemic (March 2020) with head to head comparison of the data from March 2019, considered “usual activity” period. The aim is to confront performance of Academic Centers (AC) vs Non Academic Centers (NAC) as well as non-COVID Centers (nCC) and COVID Centers (CC). Patients and methods: During April 2020, an e-mail survey was sent to 32 Sections of Urology across Italy. It contained 14 multiple-choice questions focused on activities during March 2019 and March 2020. Statistical analysis was performed using IBM SPSS Statistics (v26) software. Results28 centers answered to survey. AC and NAC showed statistically significant differences (chi-square test p<0.05) about number of physicians assigned to Covid wards (p=0.001), Trans-Urethral Resection of Bladder Tumour (TURBT) (p=0.046) and cystectomies (p=0.037) performed in March 2020 (p=0.037). In 2020, AC performed more surgical procedures compared to NAC. In 2019, AC had more procedures per Operating Block (OB) (p=0.015) and greater number of emergent Trans-Urethral Resections (TUR) (p=0.014), while NAC had more TURBTs. CC had more patients (pts) both evaluated for gross hematuria (p=0.017) and requiring haemostatic Trans-Urethral Resection (hTUR) in 2019. In 2020 nCC had more surgeries per OB (p=0.001), TURBTs (p=0.030) and cystectomies (p=0.034) than CC. ConclusionThe COVID-19 pandemic represents an important challenge for cancer centers, in the context of an extremely dynamic clinical and political situation which requires maximum flexibility to be appropriately managed.
Lessons learned from surgical management of craniovertebral instability in Morquio syndrome: A series of four unusual cases
