1.Impact of the COVID-19 Outbreak on Anesthesiologist Assistance for Endoscopic Procedures
Calcedonio CALCARA ; Camilla CISCATO ; Arnaldo AMATO ; Emanuele SINAGRA ; Costanza ALVISI ; Sandro ARDIZZONE ; Andrea ANDERLONI ; Pietro GAMBITTA ;
Clinical Endoscopy 2022;55(1):49-57
Background/Aims:
The coronavirus disease 2019 (COVID-19) outbreak has modified the activities of endoscopy units worldwide. Herein, we investigated the impact of the COVID-19 outbreak on anesthesiologist assistance for endoscopic procedures in Lombardy, Italy.
Methods:
A questionnaire concerning anesthesiologist assistance provided from October 26 to December 6, 2020, in comparison with the same period in 2019, was sent to endoscopic units in Lombardy.
Results:
Approximately 54% (34/63) of the units responded. A reduction in the number of all endoscopies (-33.5%; 18792 in 2020 vs. 28264 in 2019) and anesthesiologist-assisted endoscopies (-15.3%; 2652 in 2020 vs. 3132 in 2019) was reported. A greater reduction in anesthesiologist assistance was observed in government community units (-29.5%) than in academic (-14%) and private community units (-4.6%). Among all units, 85% reported a reduction in anesthesiologist assistance; 65% observed a delay/cancellation of procedures; 59%, a restricted patient selection; 17%, the need to transfer some patients to other hospitals; and 32%, a related worsening of procedure quality.
Conclusion
The COVID-19 pandemic compromised the anesthesiologist assistance for endoscopic procedures in Lombardy, which worsened the procedure quality mainly in government community units. The COVID-19 “stress test” suggests a more balanced allocation of anesthesiologic resources in the future.
2.Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?
Cecilia BINDA ; Emanuele DABIZZI ; Emanuele SINAGRA ; Adele FORNELLI ; Luca SARAGONI ; Vincenzo CENNAMO ; Andrea ANDERLONI ; Carlo FABBRI
Clinical Endoscopy 2021;54(4):613-617
Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it is characterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled out before any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced that permits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patient diagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling was feasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasible and safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragments in all cases, and enabled an additional assessment, i.e., immunohistochemical staining.
3.Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?
Cecilia BINDA ; Emanuele DABIZZI ; Emanuele SINAGRA ; Adele FORNELLI ; Luca SARAGONI ; Vincenzo CENNAMO ; Andrea ANDERLONI ; Carlo FABBRI
Clinical Endoscopy 2021;54(4):613-617
Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it is characterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled out before any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced that permits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patient diagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling was feasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasible and safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragments in all cases, and enabled an additional assessment, i.e., immunohistochemical staining.