Halo 194 (Jan 2020)

Acute surgical conditions in COVID-19 positive patients

  • Lončar Zlatibor,
  • Micić Dušan,
  • Petrović Nataša,
  • Laban Marija,
  • Perišić Zlatko,
  • Milenković Marija,
  • Gregorić Pavle

Journal volume & issue
Vol. 26, no. 2
pp. 69 – 74

Abstract

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Since the beginning of the COVID-19 pandemic, many articles have been published on the subject of organising surgical activity in such conditions. The object of this article is to present the published literature in order to provide key suggestions for dealing with acute surgical problems during the pandemic. A systematic overview is presented of the most relevant articles dealing with COVID-19 and surgery, published between December 30th 2019 and April 30th 2020. The operating room is reserved solely for emergency and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be assessed very carefully and critically because the virus is present in the pneumoperitoneum and its release through aerosol into the operating room can present a risk of contamination for the staff and the immediate environment. The possibility of delaying surgical procedures during the COVID-19 pandemic should be considered, until such time when the patient is no longer considered contagious or is no longer at risk of perioperative complications. If the surgery cannot be delayed, the surgeon in charge must minimize the risk of infection by including the smallest possible number of medical staff into the procedure and shortening the route the patient has to take through the hospital as much as possible. During the pandemic, open procedures take precedence. The purpose of this article is to provide surgeons with advice, so they can make decisions in the best possible interest of the patient and the surgical team, based on risk assessment for the patient (clinical presentation, comorbidity, hospital resources availability). For COVID-19 positive patients, as well as for those who are clinically highly suspected to be COVID-19 positive, nonoperative treatment is preferred if it is available and safe for the patient. If surgical procedures are necessary, personal protective equipment and all safety measures should be applied to protect the patient and the medical team.

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