Are we operating asymptomatic patients but infected with Covid19?
retrospective analysis of patients operated at the Maciel Hospital
DOI:
https://doi.org/10.31837/cir.urug.4.2.7Keywords:
surgery, mortality, asymptomatic carriers, COVID19Abstract
Introduction: Since March 2020, COVID-19 infection was declared a pandemic with consequent impact on the health system. A particular case is the surgery service with the risk linked to transmission by microdrops or pneumoperitoneum. To reduce the risk of contagion, non-oncological coordination surgeries have been suspended. The objective of this study was to assess the proportion of asymptomatic patients at the time of surgery and who developed the disease after surgery.
Materials and methods: This is an observational, descriptive and retrospective study. A search was made in the operative descriptions system of the Maciel Hospital, identifying the surgical procedures of all the specialties performed from March 16 to April 16, 2020. Demographic variables, variables related to surgery, complications and respiratory symptoms were recorded.
Results: 128 patients were included, on which 165 procedures were performed. 42.2% of the coordination procedures, 52.1% of urgency and 5.5% of emergency were performed. It is highlighted that 73.4% of the patients did not present complications and a mortality of only 7.8% was found. 9 (7.0%) swabs were performed in the period, none of them was positive.
Conclusions: COVID-19 infection is linked to an increase in postoperative mortality compared to pre-epidemic mortality, which requires strict triage to minimize risk. We highlight in our center the absence of surgery in asymptomatic patients with the infection.
Downloads
References
2. Zizzo, M.; Bollino, R.; Castro Ruiz, C.; Biolchini, F.; Bonilauri., S.; Sergi, W., et al. Surgical management of suspected or confirmed SARS-CoV-2 (COVID-19)-positive patients: a model stemming from the experience at Level III Hospital in Emilia-Romagna, Italy. ESTES, Springer. https://doi.org/10.1007/s00068-020-01377-2
3. Gallo, G.; La Torre, M.; Pietroletti, R.; Bianco.; F.; Altomare, DF.; Pucciarelli, S, et al. Italian society of colorectal surgery recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic. Techniques in Coloproctology. Springer. https://doi.org/10.1007/s10151-020-02209-6
4. Zheng, MH.; Boni, L.; Fingerhut, A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann of Surg. DOI: 10.1097/SLA.0000000000003924
5. Tan, YT.; Wang, JW.; Zhao, K.; Han, L.; Zhang, HQ.; Niu, HQ., et al. Preliminary Recommendations for Surgical Practice of Neurosurgery Department in the Central Epidemic Area of 2019 Coronavirus Infection. Current Medical Science. 40(2):281-284,2020
6. De Simone, B.; Chouillard, E.; Di Saverio, S.; Pagani, L.; Sartelli, M.; Biffl, WL., et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. Ann R Coll Surg Engl 2020; 102: 323–332
7. Balibrea, JM.; Badia, JM.; Rubio-Pérez, I.; Martín, E.; Álvarez, E.; García, S., et al. Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos. c i r e s p . 2 0 20. https://doi.org/10.1016/j.ciresp.2020.03.001
8. Tuech, J.; Gangloff, A.; Di Fiore, F.; Michel, P.; Brigand, C.; Slim, K., et al. Strategy for the practice of digestive andoncological surgery during the Covid-19epidemic. Journal of Visceral Surgery (2020), https://doi.org/10.1016/j.jviscsurg.2020.03.008
9. Castelnuovo, P.; Turri-Zanoni, M.; Karligkiotis, A.; Battaglia, P.; Pozzi, F.; Locatelli, et al. Surgery During the Covid-19 Pandemic: The Italian Skull Base Society Recommendations. Doi: 10.1111/alr.22596.
10. Stahel, P. How to risk-stratify elective surgery during the COVID-19 pandemic? Safety in Surgery (2020) 14:8
11. Vigneswaran, Y.; Prachand, V.; Posner, M.; Matthews, J.; Hussain, M. What Is the Appropriate Use of Laparoscopy over Open Procedures in the Current COVID-19 Climate? Journal of Gastrointestinal Surgery. Springer. https://doi.org/10.1007/s11605-020-04592-9
12. COVID Surg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. https://doi.org/10.1016/S0140-6736(20)31182-X
13. He, K.; Stolarski, A.; Whang, E.; Kristo, G. Addressing General Surgery Residents’ Concerns in the Early Phase of the COVID-19 Pandemic. Journal of Surgical Education. https://doi.org/10.1016/j.jsurg.2020.04.003
14. Xu, J.; Xu, QH.; Wang, CM.; Wang, J. Psychological status of surgical staff during the COVID-19 outbreak, Psychiatry Research (2020), doi: https://doi.org/10.1016/j.psychres.2020.112955
15. Gong, Y et al. Anesthesia Considerations and Infection Precautions for Trauma and Acute Care. Anesthesia & Analgesia Journal. DOI: 10.1213/ANE.0000000000004913
16. Francis, N.; Dort, J.; Cho, E.; Feldman, L.; Keller, D.; Lim, R., et al. SAGES and EAES recommendations for minimally invasive surgery during COVID19 pandemic. Surgical Endoscopy. Springer. https://doi.org/10.1007/s00464-020-07565-w
17. Rubio-Perez, I.; Badía, J.; Mora-Rillo, M.; Martín, A.; García, J.; Balibrea, JM. COVID-19: Conceptos clave para el cirujano. Cir Esp 2020 https://doi.org/doi:10.1016/j.ciresp.2020.04.009
18. Dindo, D, Demartines, N, Clavien, PA. Classification of Surgical Complications. A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey. Ann Surg 2004;240: 205–213
Downloads
Published
How to Cite
Issue
Section
License
All articles, videos and images published in Revista Cirugía del Uruguay are under the Creative Commons CC licenses, which is a complement to the traditional copyright, in the following terms: first, the authorship of the referred document must always be acknowledged and secondly none of the article or work published in the journal may have commercial purposes of any nature. The authors retain their copyrights and give the magazine the right of first publication of their work, which will be simultaneously subject to the Creative Commons Attribution-NonCommercial 4.0 International License license that allows the work to be shared whenever the initial publication is indicated in this journal.




















