DOI: http://dx.doi.org/10.18203/2349-2902.isj20204175

Surgical emergencies, onco-surgeries and colorectal surgeries in COVID-19 pandemic: practical advice based on the global experience and at Dr. D. Y. Patil Medical College, Hospital and Research Centre

Thakut Gowtham, Abhinandan Milind Kadiyal, Sheetal A. Murchite, Rajendra Madhukar Kulkarni, Vaishali Vinayak Gaikwad

Abstract


The existing coronavirus 2019 (COVID-19) pandemic is challenging healthcare systems at global level. We provide a practical strategy to reform pathways of emergency elective onco-surgery and colorectal surgery in the COVID- 19 pandemic. The novelists, from areas affected by the COVID-19, thought to outline the key-points to be conferred. Responsibilities were allotted, concerning specific characteristics of surgical emergencies, onco-surgery and colorectal surgery during the pandemic, including the administrative management of the catastrophe in India. The endorsements were collected and summarized. During the swift spread of COVID-19, it remains thoughtful to halt non-cancer procedures and prioritize surgical emergencies. Endoscopy, proctological procedures have to be completed selectively. With colorectal emergencies, a conservative approach is recommended. Detailed procedures should be followed when operating on COVID-19 patients, using committed personal protective equipment and adhering to specific rules, containing minimally invasive surgery. These guidelines summarize the strict instruction of entry/ exit into theatres and operating block as well as advice on performing procedures carefully to decrease risk of contracting the virus. It is likely that restructuring of health system is required, at central, state, and district levels. A description of the strategy adopted in Dr. D.Y. Patil Medical College Hospital, Kolhapur is provided. Evidence on the management of patients requiring surgery for surgical emergencies, onco-surgery and colorectal conditions during the COVID-19 pandemic is presently deficient. Healthcare professionals have succeeded with high volumes of surgical patients during the pandemic, could be useful to alleviate some risks and decrease exposure to other patients, public and healthcare staff.


Keywords


COVID-19 pandemic, Colorectal surgery, Onco-surgery, Surgical emergency, SARS-CoV2 infection

Full Text:

PDF

References


Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity. 2020;26:102433.

Bogoch II., Watts A, Thomas-Bachli A, Huber C, Kraemer MU et al. Pneumonia of Unknown Etiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel. Journal of Travel Medicine. 2020;27(2):taaa008.

Lu H, Stratton CW, Tang YW. Outbreak of Pneumonia of Unknown Etiology in Wuhan China: the Mystery and the Miracle. J Med Virol. 2020;92:401-2.

Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). StatPearls Publishing. 2020. Available at: https://www.ncbi.nlm.nih .gov/books/NBK554776/ Accessed on 16 May 2020.

Worldometer. 2020. Available at: https://www.worldometers.info/coronavirus/. Accessed on 16 May 2020.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382(10):970-71.

Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. New N Engl J Med. 2020;382(12):1177-79.

Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 2020;158(6):1518-19.

Song Y, Liu P, Shi XL, Chu YL, Zhang J, Xia J et al. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut. 2020;69(6):1143-44.

Zhang J, Wang S, Xue, Y. Fecal specimen diagnosis 2019 novel coronavirus–infected pneumonia. J Med Virol. 2020;92(6):680-82.

Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-33.

American College of Gastroenterology Joint GI Society Message on COVID 19. 2020. Available at: https://gi.org/2020/03/15/joint-gi-society-message-on-covid-19/. Accessed on 16 May 2020.

British Society of Gastroenterology. Endoscopy activity and COVID-19: BSG and JAG guidance. 2020. Available at: https://www.bsg.org.uk/covid-19-advice/endoscopy-activity-and-covid-19-bsg-and-jag-guidance/ Google Scholar. Accessed on 16 May 2020.

Mao R, Liang J, Shen J, Ghosh S, Zhu LR, Yang H, et al. Chinese Society of IBD, Chinese Elite IBD Union; Chinese IBD Quality Care Evaluation Center Committee. Implications of COVID-19 for patients with pre-existing digestive diseases. Lancet Gastroenterol Hepatol. 2020;30076-5.

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;21(3):335-37.

Istituto Superiore di Sanità. Report sulle caratteristiche dei pazienti deceduti positivi a COVID- 2019 in Italia. 2020. Dati al 17 marzo 2020 Available at: https://www.epicentro.iss.it/corona-virus/sars-cov-2-decessi- italia. Accessed on 16 May 2020.

Pellino G, Spinelli A. How COVID-19 Outbreak Is Impacting Colorectal Cancer Patients in Italy: A Long Shadow Beyond Infection. Dis Colon Rectum. 2020. Accessed on 16 May 2020.

Spinelli A, Pellino G. COVID-19 pandemic: perspectives on an unfolding crisis. Br J Surg. 2020.

Crohn’s & Colitis foundation UK, Cronavirus (COVID-19): Advice for people with Crohn’s and Colitis. 2020. Available at: https://www.crohn sandcolitis.org.uk/news/coronavirus-covid-19-advice. Accessed on 16 May 2020.

IOIBD Update on COVID19 for Patients with Crohn’s Disease and Ulcerative Colitis. 2020. https://www.ioibd.org/ioibd-update-on-covid19-for-patients-with-crohns-disease-and-ulcerative- colitis/. Accessed on 16 May 2020.

Delaney CP, Chang E, Senagore AJ. Clinical Outcomes and Resource Utilization Associated with Laparoscopic and Open Colectomy Using a Large National Database. Ann Surg. 2008;247:819-24.

Gerber MH, Delitto D, Crippen CJ. Analysis of the Cost Effectiveness of Laparoscopic Pancreatoduodenectomy. J Gastrointest Surg. 2017;21:1404 -10.

Repici A, Maselli R, Colombo M. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020;S0016-5107(20)30245-5.

Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J Virol. 2020;JVI.00127-20.

To KK, Tsang OT, Chik-Yan Yip C. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020;ciaa149.

Young BE, Ong SWX, Kalimuddin S. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020;e203204.

Zhang J, Wang S, Xue Y. Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia. J Med Virol. 2020;10.1002/jmv.25742.

Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology. 2020;S0016-5085(20)30281-X.

Peeri NC, Shrestha N, Rahman MS. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol. 2020;dyaa033.

Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. 2020.

Wong TW, Lee CK, Tam W. Cluster of SARS among medical students exposed to single patient, Hong Kong. Emerg Infect Dis. 2004;10(2):269-76.

Joint GI Society Message on COVID-19. 2020. https://gi.org/2020/03/15/joint-gi-society-message-on- covid-19/. Accessed on 16 May 2020.

Tse F, Borgaonkar M, Leontiadis GI. COVID-19: Advice from the Canadian Association of Gastroenterology for Endoscopy Facilities. 2020. https://www.cag- acg.org/images/publications/CAG-Statement-COVID-&-Endoscopy.pdf. Accessed on 16 May 2020.

Razai MS, Doerholt K, Ladhani S, Oakeshott P. Coronavirus disease 2019 (covid-19): a guide for UK GPs. BMJ. 2020;368:m800.

Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort. Lancet. 2020;S0140-6736(20)30566-3.

Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet 2020 10.1016/S0140-6736(20)30633-4.

Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med. 2018;178:745-6

Augestad KM, Sneve AM, Lindsetmo RO. Telemedicine in postoperative follow-up of STOMa PAtients: a randomized clinical trial (the STOMPA trial). Br J Surg. 2020;107(5):509-18.

Kontovounisios C, Smith J, Dawson P, Warren O, Mills S, Von Roon A et al. The Ostom-i™ Alert Sensor: a new device to measure stoma output. Tech Coloproctol. 2018;22(9):697-701.

Gallo G, Martellucci J, Sturiale A. Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Tech Coloproctol. 2020;24(2):145-164.

Lambrichts DPV, Birindelli A, Tonini V, Cirocchi R, Cervellera M, Lange JF et al. The Multidisciplinary Management of Acute Complicated Diverticulitis. Inflamm Intest Dis. 2018;3(2):80-90.

Di Saverio S, Sibilio A, Giorgini E, Biscardi A, Villani S, Coccolini F, et al. The NOTA Study (Non Operative Treatment for Acute Appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Ann Surg. 2014;260(1):109-17.

Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY et al. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anaesth. 2020.