COVID-19 Outbreak and Stoma Care on a Minor Island in Italy: Physically Far, Virtually Near
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COVID-19
COVID-19 Outbreak and Stoma Care on a Minor Island in Italy: Physically Far, Virtually Near Dario D’Antonio 1 & Francesco Pizza 1 & Francesca Paola Tropeano 2 & Giovanni Domenico De Palma 2 & Alberto Marvaso 1 & Gaetano Luglio 2 Accepted: 21 July 2020 / Published online: 12 August 2020 # Springer Nature Switzerland AG 2020
Abstract The current COVID-19 pandemic has considerably stressed ordinary medical resources. In such a contest, Telemedicine (TM) was relevantly recommended by several surgical societies. A specific TM-based pathway was developed emergently to care outpatients with ileo- or colostomy living on a minor island of Southern Italy (Ischia (Naples)). We retrospectively analysed a short prospective series of 23 ileo- or colostomized patients referring to a single coloproctology out-patient clinic. Patients were followed up using TM from March 3rd to April 5th 2020, when local and national policy postponed any non-emergent and nononcologic in-patient visit to a future date. Seventeen patients were eligible for observation. Tele-consulted patients were overall satisfied, with 14 of them choosing TM as their first option for a future consultation. All medical staff gave a positive feedback about TM project. The use of TM in stoma care was easily feasible in an emergent global context. To the best of our knowledge, this is the first reported experience of remote stoma care services during COVID-19 pandemic. The next challenge is to turn emergent actions into daily outpatient practice. Keywords Stoma care . Telemedicine . Covid-19 . Outpatients
The COVID-19 pandemic has considerably stressed ordinary medical resources [1]. Healthcare teams worked hard worldwide to balance risks and benefits of in-house appointments for non-urgent cases. Several surgical societies provided specific procedures and guidelines, including triaging pathways and Telemedicine (TM) during times of high disease pressure. The Society of American Gastrointestinal and Endoscopic Surgeons, the European Association for Endoscopic Surgery, the American Urological Association and the European Society of Surgical Oncology relevantly recommended TM in their documents [2]. The presence of a stoma, even in a non-emergent setting, has a great impact on patients’ quality of life, so medical and This article is part of the Topical Collection on Covid-19 * Dario D’Antonio [email protected] 1
Division of Surgery, “A. Rizzoli” Hospital, Lacco Ameno, Naples, Italy
2
Department of Gastroenterology, Endocrinology and Endoscopic Surgery, University Hospital of Naples Federico II, Naples, Italy
psychological support are needed, especially at the beginning of the stoma experience. Ischia is a very densely populated island of Southern Italy, with more than 67,000 residents on the area. About 0.14% of permanently resident population have a stoma with a total of 109 patients: 70 have a colostomy, 27 an ileostomy and 12 a urostomy/ileal conduit. Diseases requiring operations with stoma were colorectal cancer (62 (56%)), diverticulitis (24 (2
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