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

İlker Özgür; İrem Karataş; Leman Damla Ercan; Ali Fuat Kaan Gök; Alpay Medetalibeyoğlu; Murat Köse; Mehmet Türker Bulut; Metin Keskin

doi:10.26650/IUITFD.2021.821064

Research Article

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

Year 2021, Volume: 84 Issue: 3, 301 - 306, 31.07.2021

İlker Özgür İrem Karataş Leman Damla Ercan Ali Fuat Kaan Gök Alpay Medetalibeyoğlu Murat Köse Mehmet Türker Bulut Metin Keskin

https://doi.org/10.26650/IUITFD.2021.821064

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

References

1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):105924. [CrossRef]
2. Ghebreyesus T. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. https:// www.who.int/director-general/speeches/detail/whodirector- general-s-opening-remarks-at-the-media-briefingon- covid-19-11-march-2020 (Last accessed March 29, 2020)
3. Pryor A. SAGES and EAES Recommendations Regarding Surgical Response to COVID-19 Crisis. Available from URL: https://www.sages.org/recommendations-surgicalresponse- covid-19/ (Last accessed 21 January 2021)
4. Maintaining Trauma Center Access and Care during the COVID-19 Pandemic: Guidance Document for Trauma Medical Directors. Available from URL: https://www.facs. org/quality-programs/trauma/maintaining-access (Last accessed 21 January 2021)
5. U.S Department of Defense (DoD). COVID-19 Practice Management Guide V10. Available from URL: https://health. mil/Reference-Center/Technical-Documents/2020/03/24/ DoD-COVID-19-Practice-Management-Guide (Last accessed 21 January 2020)
6. American College of Surgeons (ACS). COVID-19 Guidelines for Triage of Emergency General Surgery Patients. (Updated December 8, 2020) Available from URL: https://www. facs. org/covid-19/clinical-guidance/elective-case/emergencysurgery. Last accessed 21 January 2021 2020.
7. Republic of Turkey, Ministry of Health, Public Health General Directorate, COVID-19 Guide. Available from URL: https://hsgm.saglik.gov.tr/depo/covid19/Ingilizce/Rehber/ COVID-19_Rehberi__Genel_bilgiler_epidemiyoloji_ve_ tani_8.06.2020_eng.pdf (Last accessed 8 May 2020)
8. Kucejko RJ, Holleran TJ, Stein DE, Poggio JL. How Soon Should Patients With Colon Cancer Undergo Definitive Resection? Dis Colon Rectum 2020;63(2):172-182. [CrossRef]
9. Delisle M, Helewa RM, Ward MAR, Hochman DJ, Park J, McKay A. The Association Between Wait Times for Colorectal Cancer Treatment and Health Care Costs: A Population-Based Analysis. Dis Colon Rectum 2020;63(2):160-171. [CrossRef]
10. Griffin SM, Alderson D, Taylor J, Mealy K. Updated Intercollegiate General Surgery Guidance on COVID-19. Available from: URL: https://www.acpgbi.org.uk/content/ uploads/2020/03/Updated-Intercollegiate-General- Surgery-Guidance-on-COVID-19-final-with-logos13.pdf (Last accessed 21 January 2021)
11. Karaca AS, Ozmen MM, UÇar AD, Yasti AÇ, Demİrer S. General Surgery Operating Room Practice in Patients with COVID-19. Turk J Surg 2020;36(1):i-v. [CrossRef]
12. Kamer E, Çolak T. What to Do When A Patient Infected With COVID-19 Needs An Operation: A Pre-surgery, Peri-surgery and Postsurgery Guide. Turk J Colorectal Dis 2020;30:1-8. [CrossRef]
13. Coccolini F, Perrone G, Chiarugi M, Di Marzo F, Ansaloni L, Scandroglio I, et al. Surgery in COVID-19 patients: operational directives. World J Emerg Surg 2020;15(1):25. [CrossRef]
14. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020;67(5):568-76. [CrossRef]
15. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323(14):1406-7. [CrossRef]
16. Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 - Singapore, January 23-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69(14):411-5. [CrossRef]
17. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809-15. Erratum in: Lancet 2020;395(10229):1038. Erratum in: Lancet 2020;395(10229):1038. [CrossRef]
18. Kwak HD, Kim SH, Seo YS, Song KJ. Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery. Occup Environ Med 2016;73(12):857-63. [CrossRef]
19. Gloster HM Jr, Roenigk RK. Risk of acquiring human papillomavirus from the plume produced by the carbon dioxide laser in the treatment of warts. J Am Acad Dermatol 1995;32(3):436-41. [CrossRef]
20. Hensman C, Baty D, Willis RG, Cuschieri A. Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment. An in vitro study. Surg Endosc 1998;12(8):1017-9. [CrossRef]
21. Johnson GK, Robinson WS. Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments. J Med Virol 1991;33(1):47-50. [CrossRef]
22. Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, Wall P, Spinelli A, Torkington J. Safe management of surgical smoke in the age of COVID-19. Br J Surg 2020;107(11):1406-13. [CrossRef]
23. Wexner SD, Cortés-Guiral D, Gilshtein H, Kent I, Reymond MA. COVID-19: impact on colorectal surgery. Colorectal Dis 2020;22(6):635-40. [CrossRef]
24. Angelos G, Dockter AG, Gachabayov M, Latifi R, Bergamaschi R. Emergency Colorectal Surgery in a COVID-19 Pandemic Epicenter. Surg Technol Int 2020;36:18-21.
25. Yu GY, Lou Z, Zhang W. (Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China). Zhonghua Wei Chang Wai Ke Za Zhi 2020;23(3):9-11. 2
6. Day M. Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village. BMJ 2020;368:m1165. [CrossRef]
27. Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, Yang C. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol 2020;92(7):903-8. [CrossRef]
28. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, Diao K, Lin B, Zhu X, Li K, Li S, Shan H, Jacobi A, Chung M. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020;295(3):200463. [CrossRef]
29. Li J, Feng J, Liu TH, Xu FC, Song GQ. An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report. Braz J Infect Dis 2020;24(3):247-9. [CrossRef]
30. Chen L, Lou J, Bai Y, Wang M. COVID-19 Disease With Positive Fecal and Negative Pharyngeal and Sputum Viral Tests. Am J Gastroenterol 2020;115(5):790. [CrossRef]
31. Li YK, Peng S, Li LQ, Wang Q, Ping W, Zhang N, Fu XN. Clinical and Transmission Characteristics of Covid-19 - A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department. Curr Med Sci 2020;40(2):295-300. [CrossRef]

COVID-19 VE KOLOREKTAL CERRAHİ: İLK VAKALARDAN ÖĞRENİLEN DERSLER

Year 2021, Volume: 84 Issue: 3, 301 - 306, 31.07.2021

İlker Özgür İrem Karataş Leman Damla Ercan Ali Fuat Kaan Gök Alpay Medetalibeyoğlu Murat Köse Mehmet Türker Bulut Metin Keskin

https://doi.org/10.26650/IUITFD.2021.821064

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

References

1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):105924. [CrossRef]
2. Ghebreyesus T. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. https:// www.who.int/director-general/speeches/detail/whodirector- general-s-opening-remarks-at-the-media-briefingon- covid-19-11-march-2020 (Last accessed March 29, 2020)
3. Pryor A. SAGES and EAES Recommendations Regarding Surgical Response to COVID-19 Crisis. Available from URL: https://www.sages.org/recommendations-surgicalresponse- covid-19/ (Last accessed 21 January 2021)
4. Maintaining Trauma Center Access and Care during the COVID-19 Pandemic: Guidance Document for Trauma Medical Directors. Available from URL: https://www.facs. org/quality-programs/trauma/maintaining-access (Last accessed 21 January 2021)
5. U.S Department of Defense (DoD). COVID-19 Practice Management Guide V10. Available from URL: https://health. mil/Reference-Center/Technical-Documents/2020/03/24/ DoD-COVID-19-Practice-Management-Guide (Last accessed 21 January 2020)
6. American College of Surgeons (ACS). COVID-19 Guidelines for Triage of Emergency General Surgery Patients. (Updated December 8, 2020) Available from URL: https://www. facs. org/covid-19/clinical-guidance/elective-case/emergencysurgery. Last accessed 21 January 2021 2020.
7. Republic of Turkey, Ministry of Health, Public Health General Directorate, COVID-19 Guide. Available from URL: https://hsgm.saglik.gov.tr/depo/covid19/Ingilizce/Rehber/ COVID-19_Rehberi__Genel_bilgiler_epidemiyoloji_ve_ tani_8.06.2020_eng.pdf (Last accessed 8 May 2020)
8. Kucejko RJ, Holleran TJ, Stein DE, Poggio JL. How Soon Should Patients With Colon Cancer Undergo Definitive Resection? Dis Colon Rectum 2020;63(2):172-182. [CrossRef]
9. Delisle M, Helewa RM, Ward MAR, Hochman DJ, Park J, McKay A. The Association Between Wait Times for Colorectal Cancer Treatment and Health Care Costs: A Population-Based Analysis. Dis Colon Rectum 2020;63(2):160-171. [CrossRef]
10. Griffin SM, Alderson D, Taylor J, Mealy K. Updated Intercollegiate General Surgery Guidance on COVID-19. Available from: URL: https://www.acpgbi.org.uk/content/ uploads/2020/03/Updated-Intercollegiate-General- Surgery-Guidance-on-COVID-19-final-with-logos13.pdf (Last accessed 21 January 2021)
11. Karaca AS, Ozmen MM, UÇar AD, Yasti AÇ, Demİrer S. General Surgery Operating Room Practice in Patients with COVID-19. Turk J Surg 2020;36(1):i-v. [CrossRef]
12. Kamer E, Çolak T. What to Do When A Patient Infected With COVID-19 Needs An Operation: A Pre-surgery, Peri-surgery and Postsurgery Guide. Turk J Colorectal Dis 2020;30:1-8. [CrossRef]
13. Coccolini F, Perrone G, Chiarugi M, Di Marzo F, Ansaloni L, Scandroglio I, et al. Surgery in COVID-19 patients: operational directives. World J Emerg Surg 2020;15(1):25. [CrossRef]
14. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020;67(5):568-76. [CrossRef]
15. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323(14):1406-7. [CrossRef]
16. Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 - Singapore, January 23-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69(14):411-5. [CrossRef]
17. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809-15. Erratum in: Lancet 2020;395(10229):1038. Erratum in: Lancet 2020;395(10229):1038. [CrossRef]
18. Kwak HD, Kim SH, Seo YS, Song KJ. Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery. Occup Environ Med 2016;73(12):857-63. [CrossRef]
19. Gloster HM Jr, Roenigk RK. Risk of acquiring human papillomavirus from the plume produced by the carbon dioxide laser in the treatment of warts. J Am Acad Dermatol 1995;32(3):436-41. [CrossRef]
20. Hensman C, Baty D, Willis RG, Cuschieri A. Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment. An in vitro study. Surg Endosc 1998;12(8):1017-9. [CrossRef]
21. Johnson GK, Robinson WS. Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments. J Med Virol 1991;33(1):47-50. [CrossRef]
22. Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, Wall P, Spinelli A, Torkington J. Safe management of surgical smoke in the age of COVID-19. Br J Surg 2020;107(11):1406-13. [CrossRef]
23. Wexner SD, Cortés-Guiral D, Gilshtein H, Kent I, Reymond MA. COVID-19: impact on colorectal surgery. Colorectal Dis 2020;22(6):635-40. [CrossRef]
24. Angelos G, Dockter AG, Gachabayov M, Latifi R, Bergamaschi R. Emergency Colorectal Surgery in a COVID-19 Pandemic Epicenter. Surg Technol Int 2020;36:18-21.
25. Yu GY, Lou Z, Zhang W. (Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China). Zhonghua Wei Chang Wai Ke Za Zhi 2020;23(3):9-11. 2
6. Day M. Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village. BMJ 2020;368:m1165. [CrossRef]
27. Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, Yang C. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol 2020;92(7):903-8. [CrossRef]
28. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, Diao K, Lin B, Zhu X, Li K, Li S, Shan H, Jacobi A, Chung M. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020;295(3):200463. [CrossRef]
29. Li J, Feng J, Liu TH, Xu FC, Song GQ. An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report. Braz J Infect Dis 2020;24(3):247-9. [CrossRef]
30. Chen L, Lou J, Bai Y, Wang M. COVID-19 Disease With Positive Fecal and Negative Pharyngeal and Sputum Viral Tests. Am J Gastroenterol 2020;115(5):790. [CrossRef]
31. Li YK, Peng S, Li LQ, Wang Q, Ping W, Zhang N, Fu XN. Clinical and Transmission Characteristics of Covid-19 - A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department. Curr Med Sci 2020;40(2):295-300. [CrossRef]

There are 31 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	RESEARCH
Authors	İlker Özgür 0000-0003-1499-0503 İrem Karataş This is me 0000-0002-2973-429X Leman Damla Ercan This is me 0000-0001-9637-571X Ali Fuat Kaan Gök 0000-0002-3203-1253 Alpay Medetalibeyoğlu 0000-0002-5829-9186 Murat Köse This is me 0000-0002-7487-9287 Mehmet Türker Bulut This is me 0000-0003-3311-3581 Metin Keskin This is me 0000-0002-5390-2185
Publication Date	July 31, 2021
Submission Date	November 4, 2020
Published in Issue	Year 2021 Volume: 84 Issue: 3

Cite

APA	Özgür, İ., Karataş, İ., Ercan, L. D., Gök, A. F. K., et al. (2021). COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES. Journal of Istanbul Faculty of Medicine, 84(3), 301-306. https://doi.org/10.26650/IUITFD.2021.821064
AMA	Özgür İ, Karataş İ, Ercan LD, Gök AFK, Medetalibeyoğlu A, Köse M, Bulut MT, Keskin M. COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES. İst Tıp Fak Derg. July 2021;84(3):301-306. doi:10.26650/IUITFD.2021.821064
Chicago	Özgür, İlker, İrem Karataş, Leman Damla Ercan, Ali Fuat Kaan Gök, Alpay Medetalibeyoğlu, Murat Köse, Mehmet Türker Bulut, and Metin Keskin. “COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES”. Journal of Istanbul Faculty of Medicine 84, no. 3 (July 2021): 301-6. https://doi.org/10.26650/IUITFD.2021.821064.
EndNote	Özgür İ, Karataş İ, Ercan LD, Gök AFK, Medetalibeyoğlu A, Köse M, Bulut MT, Keskin M (July 1, 2021) COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES. Journal of Istanbul Faculty of Medicine 84 3 301–306.
IEEE	İ. Özgür, “COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES”, İst Tıp Fak Derg, vol. 84, no. 3, pp. 301–306, 2021, doi: 10.26650/IUITFD.2021.821064.
ISNAD	Özgür, İlker et al. “COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES”. Journal of Istanbul Faculty of Medicine 84/3 (July 2021), 301-306. https://doi.org/10.26650/IUITFD.2021.821064.
JAMA	Özgür İ, Karataş İ, Ercan LD, Gök AFK, Medetalibeyoğlu A, Köse M, Bulut MT, Keskin M. COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES. İst Tıp Fak Derg. 2021;84:301–306.
MLA	Özgür, İlker et al. “COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES”. Journal of Istanbul Faculty of Medicine, vol. 84, no. 3, 2021, pp. 301-6, doi:10.26650/IUITFD.2021.821064.
Vancouver	Özgür İ, Karataş İ, Ercan LD, Gök AFK, Medetalibeyoğlu A, Köse M, Bulut MT, Keskin M. COVID-19 AND COLORECTAL SURGERY: LESSONS LEARNED FROM FIRST CASES. İst Tıp Fak Derg. 2021;84(3):301-6.

Download Cover Image

Article Files

Full Text

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61