Should Elective Surgical Procedures Be Delayed in Pediatric Cases in Covid-19 Pandemic? Until When? Is Pcr Required in The Preoperative Period?

Abstract

Objective: The COVID-19 pandemic has led to major changes in healthcare around the world, including postponing elective surgery. The aim of this study is to examine the COVID-19 test results in pediatric patients who are asymptomatic and have no history of contact with a COVID-19 case prior to their scheduled elective surgery.

Material and Methods: This prospective study has evaluated pediatric patients who were asymptomatic and had no contact history with a COVID-19 case and who were scheduled for elective surgery between 01.05.2020-31.10.2020 in one of the world’s largest pediatric hospitals. Nasopharyngeal swab (PCR) samples were obtained from all patients one day before the scheduled elective surgery.

Results: Eight hundred twelve patients in this study had a mean age of 6.98 ± 4.37 years. The PCR test was positive in 4 patients (0.49%), and one patient had diarrhea during the quarantine period of 15 days.

Conclusion: The low PCR positivity rate in patients scheduled for elective surgery after a detailed history and physical examination raises the question whether elective surgery can be planned without testing. Pediatric surgeons can continue elective surgical procedures by taking precautions, but without requesting PCR, in patients who are asymptomatic and have no suspicious contact history.

Keywords

• COVID-19 pandemic
• elective surgery
• pediatric patient

Covid-19 Pandemisinde Çocuklarda Elektif Cerrahi İşlemler Ertelenmeli mi? Ne zamana kadar? Preoperatif Dönemde Pcr Gerekli midir?

Abstract

Amaç: COVID-19 salgını, elektif cerrahiyi ertelemek de dahil olmak üzere dünya çapında sağlık hizmetlerinde büyük değişikliklere yol açtı. Bu çalışmanın amacı, planlanmış elektif cerrahi öncesinde bir COVID-19 vakasıyla temas öyküsü olmayan asemptomatik pediatrik hastalarda COVID-19 test sonuçlarını incelemektir.

Gereç ve Yöntemler: Bu prospektif çalışma, dünyanın en büyük pediatrik hastanelerinden birinde, 01.05.2020-31.10.2020 tarihleri arasında, asemptomatik olan, COVID-19 vakasıyla temas öyküsü olmayan ve elektif cerrahi planlanan pediatrik hastaları değerlendirdi. Tüm hastalardan planlanan elektif cerrahiden bir gün önce nazofaringeal sürüntü (PCR) örnekleri alındı.

Bulgular: Bu çalışmada 847 hastanın ortalama yaşı 6.98±4.37 yıldı. PCR testi 4 hastada (% 0.49) pozitifti ve 15 günlük karantina döneminde bir hastada ishal görüldü.

Sonuç: Ayrıntılı bir öykü ve fizik muayene sonrasında elektif cerrahi planlanan hastalarda düşük PCR pozitiflik oranı, elektif cerrahinin testsiz planlanıp planlanamayacağı sorusunu gündeme getirmektedir. Pediatrik cerrahlar asemptomatik ve temas öyküsü olmayan hastalarda önlem alarak, ancak PCR istemeden elektif cerrahi işlemlere devam edebilirler.

Keywords

• covid-19 pandemisi
• çocuk hasta
• elektif cerrahi

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