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Urgent Thoracotomy Operations In COVID-19 Era

Year 2021, Volume: 7 Issue: 3, 340 - 347, 31.12.2021
https://doi.org/10.19127/mbsjohs.983132

Abstract

Objective: This study has aimed to share the perioperative management practices and respective outcomes in patients; who underwent urgent thoracotomy due to traumatic hemothorax during the pandemic.
Methods: In a single-center, 18 patients; who underwent urgent thoracotomy due to traumatic hemothorax in March 2020 to March 2021, were included in the study retrospectively. Patient data were retrieved from digital archive files. The initial evaluation was performed in the emergency room while wearing complete personal protective equipment. Patients were taken into the operating room under emergency conditions without waiting for the results of the nucleic acid tests performed on oropharyngeal and nasopharyngeal swabs. The operation was carried out by involving the minimum number of personnel. In the postoperative period, patients were followed up in a negative pressure intensive care room. Isolation measures were maintained until two novel coronavirus nucleic acid tests on oropharyngeal and nasopharyngeal swabs collected 48 hours apart were reported as negative.
Results: During the one-year period in the COVID-19 pandemic, 18 patients were operated on with the indication of urgent thoracotomy. Of the patients, 14 were men (77.8%), and 4 were women (22.2%). Nucleic acid test results were negative in 17 patients (94.5%). The nucleic acid test result was reported positive in one patient (5.5%) for samples taken at the 48th hour. Nucleic acid tests were performed on the oropharyngeal and nasopharyngeal swabs obtained on the fifth and seventh days from the operation personnel. No novel coronavirus transmission occurred in the healthcare personnel. In the postoperative period, 15 patients (83.3%) were successfully treated and discharged from the hospital, but 3 patients (16.7%) died. No morbidity or mortality occurred due to COVID-19.
Conclusion: Urgent thoracotomies can be successfully performed during the COVID-19 pandemic. Novel coronavirus transmissions can be avoided if relevant healthcare personel comply with isolation measures and use complete personnel protective equipment

References

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  • 9. Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020 Jun;46(3):505-510. doi: 10.1007/s00068-020-01364-7.
  • 10. Lin L, Niu LL, Zheng E, Yuan Y, Ning N, Yang M. Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital. World J Virol. 2020;9(4):47-53. doi:10.5501/wjv.v9.i4.47
  • 11. Huda F, Kumar P, Singh SK, Agrawal S, Basu S. Covid-19 and surgery: Challenging issues in the face of new normal - A narrative review. Ann Med Surg (Lond). 2020;60:162-167. doi:10.1016/j.amsu.2020.10.039
  • 12. Miller L, Luković E, Wagener G. Guiding airway management and personal protective equipment for COVID-19 intubation teams. Br J Anaesth. 2020;125(3):e288-e290. doi:10.1016/j.bja.2020.06.001 13. Jheon S, Ahmed AD, Fang VW, Jung W, Khan AZ, Lee JM, Nakajima Jet al. General thoracic surgery services across Asia during the 2020 COVID-19 pandemic. Asian Cardiovasc Thorac Ann. 2020 Jun;28(5):243-249. doi: 10.1177/0218492320926886.
  • 14. Şentürk M, El Tahan MR, Szegedi LL, Marczin N, Karzai W, Shelley B, et al. Thoracic Anesthesia of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the European Association of Cardiothoracic Anaesthesiology Thoracic Subspecialty Committee. J Cardiothorac Vasc Anesth. 2020 Sep;34(9):2315-2327. doi: 10.1053/j.jvca.2020.03.059.
  • 15. Chakrabarti A, Bandyopadhyay M. Understanding the practice of thoracic surgery during the COVID-19 pandemic (published online ahead of print, 2020 Aug 11). Indian J Thorac Cardiovasc Surg. 2020;36(5):1-5. doi:10.1007/s12055-020-01025-9
  • 16. Pieracci FM, Burlew CC, Spain D, Livingston DH, Bulger EM, Davis KA, et al. Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees. Trauma Surg Acute Care Open. 2020 Apr 30;5(1):e000498. doi: 10.1136/tsaco-2020-000498.
  • 17. Ceylan KC, Batihan G, Yazgan S, Gürsoy S, Kıraklı SC, Ataman S. Pleural complications in patients with coronavirus disease 2019 (COVID-19): how to safely apply and follow-up with a chest tube during the pandemic?. Eur J Cardiothorac Surg. 2020;58(6):1216-1221. doi:10.1093/ejcts/ezaa356
Year 2021, Volume: 7 Issue: 3, 340 - 347, 31.12.2021
https://doi.org/10.19127/mbsjohs.983132

Abstract

References

  • 1. World Health Organisation Coronavirus (COVID-19) Dashboard. Available from: URL: https:// covid19.who.int/. (Accessed on March-2021).
  • 2. Calabrò L, Peters S, Soria JC, Di Giacomo AM, Barlesi F, Covre A, et al. Challenges in lung cancer therapy during the COVID-19 pandemic. Lancet Respir Med. 2020 Jun;8(6):542-544. doi: 10.1016/S2213-2600(20)30170-3.
  • 3. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-337. doi: 10.1016/S1470-2045(20)30096-6. 4. Ozturk A, Sener MU, Yilmaz A. Bronchoscopic procedures during COVID-19 pandemic: Experiences in Turkey. J Surg Oncol. 2020;122(6):1020-1026. doi:10.1002/jso.26164
  • 5. Karmy-Jones R, Jurkovich GJ, Nathens AB, Shatz DV, Brundage S, Wall MJ Jr, et al. Timing of urgent thoracotomy for hemorrhage after trauma: a multicenter study. Arch Surg. 2001 May;136(5):513-8. doi: 10.1001/archsurg.136.5.513.
  • 6. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. 7. Garcia-Castrillo L, Petrino R, Leach R, Dodt C, Behringer W, Khoury A, et al. European Society For Emergency Medicine position paper on emergency medical systems' response to COVID-19. Eur J Emerg Med. 2020 Jun;27(3):174-177. doi: 10.1097/MEJ.0000000000000701.
  • 8. Schreyer KE, Del Portal DA, King LJL, Blome A, DeAngelis M, Stauffer K, et al. Emergency Department Management of the Covid-19 Pandemic. J Emerg Med. 2020 Dec;59(6):946-951. doi: 10.1016/j.jemermed.2020.07.022.
  • 9. Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020 Jun;46(3):505-510. doi: 10.1007/s00068-020-01364-7.
  • 10. Lin L, Niu LL, Zheng E, Yuan Y, Ning N, Yang M. Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital. World J Virol. 2020;9(4):47-53. doi:10.5501/wjv.v9.i4.47
  • 11. Huda F, Kumar P, Singh SK, Agrawal S, Basu S. Covid-19 and surgery: Challenging issues in the face of new normal - A narrative review. Ann Med Surg (Lond). 2020;60:162-167. doi:10.1016/j.amsu.2020.10.039
  • 12. Miller L, Luković E, Wagener G. Guiding airway management and personal protective equipment for COVID-19 intubation teams. Br J Anaesth. 2020;125(3):e288-e290. doi:10.1016/j.bja.2020.06.001 13. Jheon S, Ahmed AD, Fang VW, Jung W, Khan AZ, Lee JM, Nakajima Jet al. General thoracic surgery services across Asia during the 2020 COVID-19 pandemic. Asian Cardiovasc Thorac Ann. 2020 Jun;28(5):243-249. doi: 10.1177/0218492320926886.
  • 14. Şentürk M, El Tahan MR, Szegedi LL, Marczin N, Karzai W, Shelley B, et al. Thoracic Anesthesia of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the European Association of Cardiothoracic Anaesthesiology Thoracic Subspecialty Committee. J Cardiothorac Vasc Anesth. 2020 Sep;34(9):2315-2327. doi: 10.1053/j.jvca.2020.03.059.
  • 15. Chakrabarti A, Bandyopadhyay M. Understanding the practice of thoracic surgery during the COVID-19 pandemic (published online ahead of print, 2020 Aug 11). Indian J Thorac Cardiovasc Surg. 2020;36(5):1-5. doi:10.1007/s12055-020-01025-9
  • 16. Pieracci FM, Burlew CC, Spain D, Livingston DH, Bulger EM, Davis KA, et al. Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees. Trauma Surg Acute Care Open. 2020 Apr 30;5(1):e000498. doi: 10.1136/tsaco-2020-000498.
  • 17. Ceylan KC, Batihan G, Yazgan S, Gürsoy S, Kıraklı SC, Ataman S. Pleural complications in patients with coronavirus disease 2019 (COVID-19): how to safely apply and follow-up with a chest tube during the pandemic?. Eur J Cardiothorac Surg. 2020;58(6):1216-1221. doi:10.1093/ejcts/ezaa356
There are 14 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research articles
Authors

Barış Hekimoğlu 0000-0002-1724-9836

Muhammet Ali Beyoğlu 0000-0003-4038-630X

Mehmet Şahin 0000-0002-7652-624X

Publication Date December 31, 2021
Published in Issue Year 2021 Volume: 7 Issue: 3

Cite

Vancouver Hekimoğlu B, Beyoğlu MA, Şahin M. Urgent Thoracotomy Operations In COVID-19 Era. Mid Blac Sea J Health Sci. 2021;7(3):340-7.

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