A worldwide survey on proctological practice during COVID‐19 lockdown (ProctoLock 2020): a cross‐sectional analysis

Abstract

Aim Proctology is one of the surgical specialties that has suffered the most during COVID‐19 pandemic. Using a cross‐sectional non‐incentivised World Wide Web survey, we aimed to snapshot the current status of proctological practice in six world regions. Method Surgeons affiliated to renowned scientific societies with an interest in coloproctology were invited to join the survey. Members of the ProctoLock Working Group enhanced recruitment by direct invitation. The predictive power of respondents’ and hospitals’ demographics on the change of status of surgical and outpatient activities was calculated. Results Respondents ( n = 1050) were mostly men (79%), with a mean age of 46.9 years, at consultant level (79%), practising in academic hospitals (53%) offering a dedicated proctology service (68%). A total of 119 (11%) tested positive for SARS‐CoV‐2. The majority (54%) came from Europe. Participants from Asia reported a higher proportion of unaltered practice (17%), while those from Europe had the highest proportion of fully stopped practice (20%). The likelihood of ongoing surgical practice was higher in men (OR 1.54, 95% CI 1.13–2.09; P = 0.006), in those reporting readily availability of personal protective equipment (PPE) (OR 1.40, 1.08–1.42; P = 0.012) and in centres that were partially or not at all involved in COVID‐19 care (OR 2.95, 2.14–4.09; P < 0.001). This chance decreased by 2% per year of respondent’s age ( P = 0.001). Conclusion Several factors including different screening policies and resource capacity affected the current status of proctological practice. This information may help health authorities to formulate effective preventive strategies to limit curtailment of care of these patients during the pandemic.

Proctologic Surgery Prioritization After the Lockdown: Development of a Scoring System

“…Elective surgery for benign conditions faced a cancelation of procedures to an estimate of 71.2-87.4% (2). The practice of surgical coloproctology was heavily affected by this lockdown, since most operations performed in this area were for benign, functional disorders (4)(5)(6).…”

“…Elective operations for coloproctological diseases suffered noticeably since they had been completely canceled at the time of the lockdown (4)(5)(6). Delayed surgery even for benign or functional disease may result in complications, unplanned emergency surgery, deterioration of individual health, disability, and social costs (7,8).…”

Patients waiting lists and the COVID-19 pandemic: A moral dilemma

“…However, 48,9% of the survey respondents reported a change in the initial surgical plan, and 26,3% reported a shift from elective to urgent operations. 5 Another worldwide survey on proctological practices conducted by Gallo et al 6 showed that 119 participants (11%) tested positive for SARS-CoV-2, and the participants from Asia reported a higher proportion of unaltered practice (17%). At the same time, those from Europe had the highest proportion of completely stopped practice (20%).…”

“…Nevertheless, the authors 6 stated, "Surprisingly, PPE was deemed readily available by only 71% of respondents worldwide, ranging from <33% in Africa and South America to >80% in North America." This result may reflect resource management policies that do not always meet risk prevention.…”

Hospitals and the Covid19 pandemic: challenges and opportunities for transformation

“…Lo que resulta muy interesante es cómo los profesionales en los hospitales han encontrado la manera de aprender rápidamente de la gran experiencia acumulada gracias a la metodología investigadora para terminar incorporando el conocimiento generado en su propia práctica y diseminándolo para que fuera útil a otros, durante la pandemia y como herramienta para la recuperación de la actividad programada (8)(9)(10)(11)(12)(13)(14)(15)(16).…”