Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Impact of the COVID-19 Outbreak on Anesthesiologist Assistance for Endoscopic Procedures

  • Calcedonio Calcara (Endoscopy Unit, ASST Ovest Milanese) ;
  • Camilla Ciscato (Gastroenterology and Digestive Endoscopy Unit, ASST Ovest Milanese) ;
  • Arnaldo Amato (Gastroenterology Division, Valduce Hospital) ;
  • Emanuele Sinagra (Gastroenterology and Endoscopy Unit, Institute Foundation G. Giglio) ;
  • Costanza Alvisi (Endoscopy Unit, Voghera and Vigevano Hospitals-ASST Pavia) ;
  • Sandro Ardizzone (Gastroenterology and Endoscopy Unit, Fatebenefratelli-Sacco ASST) ;
  • Andrea Anderloni (Division of Gastroenterology and Digestive Endoscopy, IRCCS Humanitas Research Hospital) ;
  • Pietro Gambitta (Endoscopy Unit, ASST Ovest Milanese)
  • Received : 2021.06.17
  • Accepted : 2021.09.24
  • Published : 2022.01.30
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Abstract

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.

Keywords

Acknowledgement

Members of the FISMAD Lombardy COVID-19 Impact on Anesthesiologis-Assisted Endoscopy Study Group: Roberto Grassia, Gastroenterology and Digestive Endoscopy Unit, ASST Cremona, Cremona, Italy; Aurora Giannetti, Digestive Endoscopy Unit, IRCCS Multimedica Sesto San Giovanni, Milan, Italy; Francesco Broglia, Digestive Endoscopy and Gastroenterology Unit, ASST Lodi, Lodi, Italy; Paolo Giorgio Arcidiacono, Biliopancreatic Endoscopy and Endoscopic Ultrasonography Unit , IRCCS San Raffaele Hospital, Milan, Italy; Mauro Ghirardi, Digestive Endoscopy Service, Istituto Clinico Citta di Brescia, Brescia, Italy; Kareem Khalaf, Digestive Endoscopy Unit, Humanitas Research Hospital, Rozzano, Milan, Italy; Fabio Chicco, Digestive Endoscopy Unit, Voghera and Vigevano Hospitals-ASST Pavia, Pavia, Italy; Mario Gatti, Gastroenterology and Digestive Endoscopy Unit, ASST Brianza, Carate Brianza, Monza-Brianza, Italy; Thomas Togliani, Digestive Endoscopy Unit, Carlo Poma Hospital-ASST Mantova, Mantova, Italy; Marco Parravicini, Gastroenterology Unit, ASST Settelaghi, Varese, Italy; Stefano Bargiggia, Endoscopy and Gastroenterology Unit, San Carlo Clinic, Paderno Dugnano, Milan, Italy; Massimiliano Mutignani, Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Lorella Fanti, Digestive Endoscopy Unit, IRCCS San Raffaele Hospital, Milan, Italy; Luca Ferraris, Gastroenterology Unit, ASST Valleolona, Gallarate, Varese, Italy; Rocco Putignano, Gastroenterology and Digestive Endoscopy Unit, ASST Ovest Milanese, Legnano, Milan, Italy; Vincenzo Occhipinti, Digestive Endoscopy and Gastroenterology Unit, Manzoni Hospital-ASST Lecco, Lecco, Italy; Loretta Amato, Gastroenterology and Digestive Endoscopy Unit, ASST Melegnano-Martesana, Melzo, Milan, Italy; Stenio Rosato, Digestive Endoscopy Unit, ASST Valcamonica, Esine, Brescia, Italy; Elia Armellini, Gastroenterology Unit, ASST Bergamo Est, Seriate, Bergamo, Italy; Ivana Zappa, Digestive Endoscopy Service, Minimally Invasive Surgery Division, ASST Lariana, Cantu, Como, Italy; Francesca Boni, Digestive Endoscopy Unit, ASST Melegnano-Martesana, Vizzolo Predabissi, Milan, Italy; Alessandro Longhini, Digestive Endoscopy Unit, ASST Valtellina e Alto Lario, Sondrio, Italy; Gianni Santo Mezzi, Digestive Endoscopy Unit, ASST Brianza, Vimercate, Monza-Brianza, Italy; Guido Missale, Digestive and Interventional Endoscopy Unit, ASST Spedali Civili, Brescia, Italy; Giuseppe Di Flumeri, Digestive Endoscopy Unit, ASST Franciacorta, Chiari, Brescia, Italy; Giuseppe De Roberto, Digestive Endoscopy Unit, European Institute of Oncology, Milano, Italy; Federico De Grazia, Digestive Endoscopy Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Licia Snider, Gastroenterology and Digestive Endoscopy Unit, ASST Lariana, Como, Italy; Paola Fontana, Digestive Endoscopy Unit, ASST Ovest Milanese, Magenta, Milan, Italy; Roberto Penagini, Gastroenterology and Digestive Endoscopy Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Milano, Italy; Benedetto Mangiavillano , Digestive Endoscopy Unit, Humanitas Mater Domini, Castellanza, Vvarese, Italy. We are grateful to Dr. Kareem Khalaf for reviewing the English language of our manuscript.

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