While the Novel Coronavirus (COVID-19) pandemic looks to persist, institutions promote delaying procedures. Understanding trends and demands of interventional radiology (IR) procedures in the infected and COVID-free populations are needed in long-term planning. We detail IR procedure trends in the first 27 weeks of the pandemic and compare with the pre-pandemic era. In this IRB approved retrospective electronic case review, all IR patients in our institution from 1 January to 9 July 2020, the same period in 2019 pre-pandemic and the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak were included. IR procedures were classified using Interventional Radiology—Procedure Acuity Scale (IR-PAS) and category of IR procedures. Along with descriptive frequencies, the Mann–Whitney U test and Chi-square test of independence were performed. During the pandemic, 3655 IR procedures were performed compared to 3851 procedures pre-pandemic. No statistically significant difference in weekly IR caseloads across IR-PAS tiers between both periods (p = .088) and category of procedure (p = .054) were noted. General intervention procedures remained the largest proportion and musculoskeletal procedures the minority, in both periods. More general intervention radiology and oncology procedures were performed during the COVID-19 pandemic compared to the SARS-CoV outbreak. Thirty-four (0.93%) IR procedures were performed on 30 COVID-19 patients. There was no IR procedure-related COVID-19 cross-transmission. Demand for IR procedures among COVID-free patients remains high, and IR procedures involving COVID-19 represents a fraction of the IR caseload. A sustainable model in providing timely IR services to COVID-free patients needs to be considered.

/pdf/trends-of-interventional-radiology-procedures-during-the-3lfkc5xixj.pdf

Trends of interventional radiology procedures during the COVID-19 pandemic: the first 27 weeks in the eye of the storm.

Management of Postoperative Complications Following Common Pediatric Operations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801775

Impact of the first year of the COVID-19 pandemic on an interventional radiology unit

Dear Editor, We read with keen interest the article titled BIs Interval Appendectomy Necessary for Appendicular Phlegmon? A Prospective Study^ by Motie et al. published in 2017 issue of the Indian Journal of Surgery [1]. Acute appendicitis (AA) is one of the most common surgical emergency worldwide (7–8%) [2]. Standard treatment of AA is appendectomy [2]. However, in recent years, publications have reported that antibiotherapymay be used in uncomplicated appendicitis [2]. However, no consensus was achieved in the treatment guidelines regarding the approach to complicated appendicitis [3]. In a study of Miftaroski et al., interval appendectomy was recommended after antibiotic treatment in the case of < 3-cm abscess or phlegmonous appendicitis [3]. Motie et al. divided patients into three groups as A, B, and C in their study. Group A consisted of the patients that were followed up for a month after discharge from the hospital. In this group, it is understood that only conservative treatment was applied for the patients. Authors should clarify that point. The remaining patients were randomly divided into groups B and C. For readers, it is important that the authors specify randomization methods. In addition, patients in a group underwent interval appendectomy while the patients in another group were treated only conservatively. Patients in group C constitute a very risky group for a prospective study. We wonder what kind of explanation was made to the patients in group C about the study. Also, it was not mentioned which method for interval appendectomy was performed (open or laparoscopic). The authors followed up the patients after discharge in group A and C during 1 month and 6 months, respectively. We believe that it will be worthwhile to share their thoughts about the criteria they used to designate these follow-up times and why they did not insert group A to randomization.

https://link.springer.com/content/pdf/10.1007%2Fs12262-017-1682-3.pdf

Significant Points in Complicated Appendicitis

Abstract Purposes: The purpose of the present paper was to prove the efficacy of Percutaneous Cholecystostomy (PC) in the treatment of patients with Acute Cholecystitis (AC) before the COVID-19 pandemic and especially during the pandemic, and to show that it is a safe procedure for patients and healthcare professionals.Materials and Methods: The demographic data of the patients with AC who applied to our hospital, who underwent PC procedure in the 24-month and 12-month period before and during the pandemic, clinical and laboratory data, technical success of PC, clinical response to treatment, length of hospital stay, one-month postprocedural observation, and complications were compared.Results: PC was applied to a total of 124 patients in the pre-pandemic period (52) and pandemic period (72) examined in the study. The median age was 73.5 (25–93) in the pre-pandemic period, and 64 (23–90) in the pandemic period, and the difference between these was found to be significant (p = 0.004). Clinical improvement due to PC was detected in 43 (86%) patients in the pre-pandemic period, and in 61 (84.7%) patients in the pandemic period, no significant differences were detected between the two groups (p = 1.000). The day of hospitalization median value was 3 (1–18) days in pandemic period, and 3 (1–30) days in the pandemic period, and no significant differences were detected between the groups (p = 0.794).ConclusionPC treatment in patients with AC during the pandemic andpre-pandemicc period is effective and safe for both the patient and the healthcare professionals who perform the procedure.The efficacy of percutaneous cholecystostomy in patients with acute cholecystitis before and during the COVID-19 pandemic. Is the percutaneous cholecystostomy procedure safe for patients and healthcare professionals in pandemic conditions? 

The efficacy of percutaneous cholecystostomy in patients with acute cholecystitis before and during the COVID-19 pandemic. Is the percutaneous cholecystostomy procedure safe for patients and healthcare professionals in pandemic conditions?

Given the importance of continuum in providing services and exigence of protecting health care professionals during this period, the Swiss Society of Vascular and Interventional Radiology (SSVIR) is releasing guidance for interventional radiologists as preparedness to manage COVID-19 patients, the workflow of non-COVID-19 patients and optimize interactions with other healthcare professionals.

Interventional radiology workflow during the COVID-19 pandemic: recommendations of the Swiss Society of Vascular and Interventional Radiology.

Principles Optimal management of perforated appendicitis with perityphlitic phlegmon or abscess formation is controversial. The aim of the study was to assess the outcome after a two-step procedure to treat patients with perityphlitic abscess formation. Methods We retrospectively assessed prospectively collected data from a single-centre database that included adult patients who had appendicitis and perityphlitic abscess (>=3 cm) but no generalised peritonitis, and were treated in 2007-2015. Patients underwent a two-step procedure that comprised antibiotic treatment and drainage when technically feasible (step 1) followed by interval appendectomy (step 2). We evaluated treatment modalities, complications and outcomes. Results Out of a total of 1480 patients with appendicitis, 15 patients presented with perityphlitic abscess. In addition to antibiotic treatment, computed tomography-guided drainage was performed in 12 of these cases. Step 1 and 2 hospital stays were (median, range) 7 days (5–14 days) and 2 days (2–12 days), respectively. One patient’s abscess recurred after 2 months, associated with new onset appendicitis and perforation. Another patient underwent reoperation after interval appendectomy for suspected postoperative peritonitis. Conclusion This two-step procedure for appendicitis with appendicular abscess was highly successful (100%) with a low rate of complications (13%). In the view of a potentially increased rate of appendicular neoplasm in combination with abscess formation, the role of interval appendectomy has to be evaluated in larger trials.

Two-step procedure for complicated appendicitis with perityphlitic abscess formation

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Interventional radiology workflow during the COVID-19 pandemic: recommendations of the Swiss Society of Vascular and Interventional Radiology.

Two-step procedure for complicated appendicitis with perityphlitic abscess formation