COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES

Abstract

Objective: This study aimed to examine the preoperative, perioperative, and postoperative colorectal surgery experience during the initial stage of the pandemic outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) later named COVID-19 disease in Turkey and to assess conditions and needs. Material and Method: Seven early cases of colorectal disease patients are described and lessons learned from these cases are reported. All patients’ preoperative workup included two nasopharyngeal polymerase chain reaction (PCR) swabs for SARSCoV- 2 taken at a three-day interval preoperatively and a thorax computerized tomography scan taken on a preoperative day. Results: COVID-19 infection occurred before and after surgery despite all measures taken, including isolation. It became complicated to manage surgical complications such as stoma complication, surgical site infection, and small bowel obstruction. Nonetheless, while patients with underlying health conditions have a high mortality rate from COVID-19 infection, no death was observed in this small case series. Conclusion: Medical centers must be well organized to perform colorectal surgery under pandemic conditions. Patients may initially test negative or become positive for COVID-19 at any stage during this disease outbreak. Multidisciplinary teamwork with the infectious disease department and anesthetists can prevent mortality from COVID-19 infection during colorectal surgery and subsequent hospitalization.

Keywords

• Colorectal surgery
• COVID-19 pandemic
• laparoscopic surgery

COVID-19 VE KOLOREKTAL CERRAHİ: İLK VAKALARDAN ÖĞRENİLEN DERSLER

Abstract

Amaç: Bu çalışmanın amacı, sonralarda COVID-19 pandemisi olarak adlandırılan, şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) pandemi salgınının ilk yayılım aşamasında ameliyat süreçlerinde kolorektal cerrahi deneyimini incelemek, koşulları ve ihtiyaçları değerlendirmektir. Gereç ve Yöntem: Salgının erken döneminde ameliyat edilen yedi kolorektal hastalık vakası tanımlandı ve öğrenilen dersler rapor edildi. Tüm hastalarda ameliyat öncesi tarama, SARS-CoV-2 için üç gün arayla alınan iki nazofaringeal sürüntü polimeraz zincir reaksiyonu (PCR) testi ve toraks bilgisayarlı tomografi ile yapıldı. Bulgular: İzolasyon dâhil alınan tüm önlemlere rağmen, COVID- 19 enfeksiyonu ameliyattan önce de, sonra da gelişti. Hastalarda ameliyat sonrası gelişen stoma komplikasyonu, cerrahi yara yeri enfeksiyonu ve ileus gibi komplikasyonları yönetmek karmaşık hale geldi. Bununla birlikte, COVID-19 enfeksiyonu varlığında altta yatan sağlık sorunu olan hastalar için bildirilen yüksek ölüm oranına rağmen, bu küçük vaka serisinde herhangi bir hasta kaybı olmadı. Sonuç: Pandemi koşullarında kolorektal cerrahi yapan ve sağlık hizmeti veren merkezler iyi organize edilmelidir. Hastaların COVID-19 testleri ameliyat öncesi dönemde negatif olmasına rağmen, ameliyat sürecinin herhangi bir aşamasında pozitife dönüşebilir. Multidisipliner ekip çalışması, başlıca enfeksiyon hastalıkları, anestezi ve reanimasyon ekibi ve kolorektal cerrahlar ile COVID-19 enfeksiyonundan ölümler önlenebilir.

Keywords

• Kolorektal cerrahi
• Covid-19 pandemisi
• laparoskopik cerrahi

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