COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES/COVID-19 VE KOLOREKTAL CERRAHI: ILK VAKALARDAN OGRENILEN DERSLER

• Published in: İstanbul Tıp Fakültesi dergisi = Journal of the Istanbul Faculty of Medicine Vol. 84; no. 3; p. 301
• Main Authors: Ozgur, Ilker, Karatas, Irem, Ercan, Leman Damla, Gok, Ali Fuat Kaan, Medetalibeyoglu, Alpay, Kose, Murat, Bulut, Mehmet Turker, Keskin, Metin
• Format: Journal Article
• Language: English
• Published: AVES 01.09.2021
• Subjects: Colorectal surgery; Control; Epidemics; Patient outcomes; Perioperative care; Risk factors; Turkey; Turkey
• ISSN: 1305-6433
• DOI: 10.26650/IUITFD.2021.821064

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 SARS-CoV-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 Amac: Bu calismanin amaci, sonralarda COVID-19 pandemisi olarak adlandirilan, siddetli akut solunum sendromu koronavirus 2 (SARS-CoV-2) pandemi salgininin ilk yayilim asamasinda ameliyat sureclerinde kolorektal cerrahi deneyimini incelemek, kosullari ve ihtiyaclari degerlendirmektir. Gerec ve Yontem: Salginin erken doneminde ameliyat edilen yedi kolorektal hastalik vakasi tanimlandi ve ogrenilen dersler rapor edildi. Tum hastalarda ameliyat oncesi tarama, SARS-CoV-2 icin uc gun arayla alinan iki nazofaringeal suruntu polimeraz zincir reaksiyonu (PCR) testi ve toraks bilgisayarli tomografi ile yapildi. Bulgular: Izolasyon dahil alinan tum onlemlere ragmen, COVID-19 enfeksiyonu ameliyattan once de, sonra da gelisti. Hastalarda ameliyat sonrasi gelisen stoma komplikasyonu, cerrahi yara yeri enfeksiyonu ve ileus gibi komplikasyonlari yonetmek karmasik hale geldi. Bununla birlikte, COVID-19 enfeksiyonu varliginda altta yatan saglik sorunu olan hastalar icin bildirilen yuksek olum oranina ragmen, bu kucuk vaka serisinde herhangi bir hasta kaybi olmadi. Sonuc: Pandemi kosullarinda kolorektal cerrahi yapan ve saglik hizmeti veren merkezler iyi organize edilmelidir. Hastalarin COVID-19 testleri ameliyat oncesi donemde negatif olmasina ragmen, ameliyat surecinin herhangi bir asamasinda pozitife donusebilir. Multidisipliner ekip calismasi, baslica enfeksiyon hastaliklari, anestezi ve reanimasyon ekibi ve kolorektal cerrahlar ile COVID-19 enfeksiyonundan olumler onlenebilir. Anahtar Kelimeler: Kolorektal cerrahi, COVID-19 pandemisi, laparoskopik cerrahi