The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.

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This study describes the specific use and sealing ability of Hemopatch® in patients undergoing routine laparoscopic cholecystectomy.Methods: A multicenter, prospective, open-label, non-randomized, control-group comparison was performed to compare the effects of adjunct Hemopatch® in patients undergoing laparoscopic cholecystectomy. The primary endpoint was the reduction of post-operative hospitalization. Secondary endpoints were the amount of post-operative drainage within the initial 6 hours, the total volume of drainage during 72 hours post-operatively, the need for re-operative/re-admission, and reported complications.Results: one hundred and fifty two consecutive patients were enrolled between March 2016 and May 2018. In 78 (51.3%) of these patients, Hemopatch® was used as an adjunct to surgical hemostasis to obtain hemostasis of the resected areas in the gallbladder bed. The remaining 74 patients (48.7%, the control-group) underwent a standard laparoscopic cholecystectomy using only L-shaped monopolar electrode and clip. No difference was observed between the groups in post-operative hospitalization course and most endpoints, including no surgical re-operations or re-admission in any patient. However, a substantially higher proportion of those in the adjunct Hemopatch® than the control group had no drainage after 6 hours (48.7% [38/78] and 16.2% [12/74], respectively; p < 0.001). In an analysis of drained volume, 30.7% (24/78) Hemopatch® cases and 13.5% (10/74) control cases had empty drains (p = 0.011). Reported complications occurred in 13.2% of cases, with 11.8% in the Hemopatch® cases and 1.4% in the control group. Conclusion:These findings suggest that the adjunctive use of Hemopatch® in patients undergoing elective laparoscopic cholecystectomy is safe and easy to utilize and that its sealing ability reduces the amount of post-operative site drainage.

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Intra-thyroid metastases are a rare occurrence. Previous research characterized melanoma and breast carcinoma as the commonest primary lesions leading to thyroid metastases, but more recent studies demonstrate that renal cell carcinoma (RCC) is now the most prevalent. The aims of this study is to report our experience and to analyze the clinical characteristics of patients with thyroid involvement of RCC