Approach to General Surgery Practice Durıng Covid-19 Pandemic

Yıl 2020, Sayı: Special Issue on COVID 19, 102 - 110, 20.03.2020

Orhan Alimoğlu , Cem Ilgın Erol

https://doi.org/10.21673/anadoluklin.719805

Cited By: 7

Öz

In December 2019, pneumonia cases with unknown cause occurred in Wuhan City, China's Hubei Province. As a result of their studies, Chinese scientists revealed that the agent causing pneumonia in these patients was 'severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously known as 2019-nCoV)'. The disease was introduced in the literature in February 2020 as Coronavirus Disease 2019 (COVID-19). In the following times, the disease spread rapidly, and on March 11, 2020, the World Health Organization (WHO) declared pandemic. COVID-19 does not currently have an antiviral treatment available, and treatment is focused on respiratory support. The high level of contagiousness and its characterization with pneumonia that can be mortal have made COVID-19 a public health problem that should be concerned beyond being just an infectious pandemic. Proper management of patients within the surgical indication during pandemic is important both to prevent emergency-related mortality and to manage cancer patients correctly in the process. In this study, we tried to review the information in the literature about how general surgical clinical practices should be carried out during the pandemic process. In the light of this information, we emphasized the importance of protecting healthcare workers, usage of personal protective equipment, management of surgical emergencies and cancer patients during the COVID-19 pandemic.

Anahtar Kelimeler

COVID-19, SARS-Cov2, general surgery, emergency, cancer

Covid-19 Pandemisi Sırasında Genel Cerrahi Uygulamalarına Yaklaşım

Öz

Aralık 2019’da Çin’in Hubei eyaletinin Wuhan kentinde sebebi bilinmeyen pnömoni vakaları ortaya çıktı. Çinli bilim insanlar yaptığı çalışmalar sonucunda bu hastalarda pnomoniye neden olan etkenin ‘severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; daha önce bilinen ismiyle 2019-nCoV)’ olduğunu ortaya koydu. Hastalık Şubat 2020’de literatüre Coronavirüs Hastalığı 2019 (COVID-19) olarak geçti. Takip eden zamanlarda hastalık hızlı bir şekilde yayıldı ve 11 Mart 2020’de Dünya Sağlık Örgütü (DSÖ) pandemi ilan etti. Bu makale kaleme alındığında COVID-19’un halihazırda mevcut bir antiviral tedavisi yoktur ve tedavinin temelinde solunum desteğine odaklanılmaktadır. Yüksek bulaşıcılık düzeyi ve mortal seyredebilen pnömoni ataklarıyla karakterize oluşu COVID-19’u sadece enfeksiyöz bir pandemi olmanın ötesinde kaygı duyulması gereken bir halk sağlığı problemi haline getirmiştir. Pandemi sırasında cerrahi endikasyon dahilindeki hastaların doğru yönetilmesi hem acil durumlara bağlı mortalitenin önüne geçmek, hem de kanser hastalarının süreç içerisinde doğru yönetilebilmesi için önemlidir. Bu çalışmamızda pandemi sürecinde genel cerrahi klinik uygulamalarının nasıl yürütülmesi gerektiği hakkında literatürdeki bilgileri derlemeye çalıştık. Bu bilgiler ışığında COVID-19 pandemisi sırasında sağlık çalışanlarının korunmasının, cerrahi acillerin ve kanser hastalarının yönetiminin önemini vurguladık.

Anahtar Kelimeler

COVID-19, SARS-Cov2, genel cerrahi, ameliyathane, acil olgular, kanser

Kaynakça

• He F, Den, Y, Li W. Coronavirus disease 2019: What we know? J Med Virol. 2020; 1– 7.
• Pellino G, Spinnelli A. How COVID-19 outbreak is impacting colorectal cancer patients in Italy: A long shadow beyond infection. Dis Colon Rectum[journal on the Internet]. 2020 Mar 17 [cited 2020 Apr 10]. Available from: https://journals.lww.com/dcrjournal/Citation/publishahead/How_COVID_19_Outbreak_Is_Impacting_ColColorec.99704.aspx [Epub ahead of print]
• Li Q, Guan X, Wu P et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-1207.
• Velavan TP, Meyer CG. The COVID‐19 epidemic. Trop Med Int Health, 25: 278-280.
• Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020 Mar 13;7(1):11.
• Holshue ML, DeBolt C, Lindquist S at al. First case of 2019 novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-936.
• Kamer E, Colak T. What to do when a patient infected with COVID-19 needs an aperation: A pre-surgery, peri-surgery and post-surgery guide. Turk J Colorectal Dis 2020;30:1-8
• Yu J, Ouyang W, Chua MLK, et al. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol [journal on the Internet]. 2020 Mar 25 [cited 2020 Apr 10]. Available from : https://jamanetwork.com/journals/jamaoncology/fullarticle/2763673 [Epub ahead of print]
• Nassar AH, Zern NK, McIntyre LK, et al. Emergency restructuring of a general surgery residency program during the coronavirus disease 2019 pandemic: The University of Washington experience. JAMA Surg [journal on the Internet]. 2020 Apr 6. [cited 2020 Apr 10]. Available from : https://jamanetwork.com/journals/jamasurgery/fullarticle/2764317 [Epub ahead of print]
• American Collage of Surgeon COVID-19: Elective case triage guidelines for surgical care. [homepage on the Internet] c2020 [updated 2020 Mar 24; cited 2020 Apr 10] Available from: https://www.facs.org/covid-19/clinical-guidance/elective-case
• Liang W, Guan W, Chen R, at al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-337.
• Yu GY, Lou Z, Zhang W. Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China. Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Feb 19;23(3):9-11.
• Luo Y, Zhong M. Standardized diagnosis and treatment of colorectal cancer during the outbreak of corona virus disease 2019 in Renji hospital. Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Mar 25;23(3):211-216.
• National Comprehesive Cancer Network principles for management of colorectal cancer patients during the COVID-19 pandemic [homepage on the Internet] c2020 [updated 2020 Apr 6; cited 2020 Apr 10]. Available from: https://www.nccn.org/covid-19/pdf/Colorectal%20COVID-19.pdf
• Society of Surgical Oncology resource for management options of GI and HPB cancers during COVID-19 [homepage on the Internet] c2020 [updated 2020 Apr 6; cited 2020 Apr 10]. Available from: https://www.surgonc.org/wp-content/uploads/2020/04/GI-and-HPB-Resource-during-COVID-19-4.6.20.pdf
• European Society Of Endocrine Surgeons : Prioritisation of endocrine surgery during the COVID-19 pandemic. [homepage on the Internet] c2020 [updated 2020 Mar 24; cited 2020 Apr 10]. Available from : https://www.endokrincerrahisi.org/files/file/NL-2020-Prioritisation_of_Endocrine_Surgery_during_the_Covid-19_pandemic-ESES_2020.pdf
• Chiu PWY, Ng SC, Inoue H, et al. Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut [journal on the Internet]. 2020 Apr 2. [cited 2020 Apr 10] pii: gutjnl-2020-321185. Available from : doi: 10.1136/gutjnl-2020-321185 [Epub ahead of print]
• Xiao F, Tang M, Zheng X, et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020 Mar 3. pii: S0016-5085(20)30282-1
• Karaca AS, Ozmen MM, Ucar AD, Yasti AC, Dermirer S. General Surgery Operating Room Practice in Patients with COVID-19. Turk J Surg 2020; 36 (1): VI-X
• Cai H, Chen Y et al. “Handbook of COVID-19 Prevention and Treatment”, The First Affiliated Hospital, Zhejiang University School of Medicine : Alibabacloud ; 2020.
• Ti LK, Ang LS, Foong TW et al. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anesth [journal on the Internet]. 2020 Mar 6. [cited 2020 Apr 10]. Available from: https://link.springer.com/article/10.1007/s12630-020-01617-4 [Epub ahead of print]
• SAGES and EAES Recommendations Regarding Surgical Response To Covid-19 Crisis [homepage on the Internet] c2020 [updated 2020 Mar 30; cited 2020 Apr 10]. Available from: https://www.sages.org/recommendations-surgical-response-covid-19/
• Türkiye Kanser İstatistikleri,2015. T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, 2018.