Экстренная хирургическая помощь в условиях инфекционного стационара — актуальная проблема во время пандемии новой коронавирусной инфекции COVID-19. Городская клиническая больница № 15 имени О. М. Филатова оказывает экстренную хирургическую помощь в условиях перепрофилирования с 27 марта 2020 г. по настоящее время. Специалистами больницы накоплен большой практический опыт: в апреле 2020 г. выполнено 194, а в мае — 289 оперативных пособий. В статье представлен опыт работы экстренной хирургической службы на этапе перепрофилирования в инфекционный стационар. Среди всех госпитализированных пациентов 482 (5,29%) имели острую хирургическую патологию, потребовавшую экстренного оперативного вмешательства. У 472 (98%) экстренно прооперированных пациентов присутствовала вызванная COVID-19 внебольничная пневмония разной степени тяжести. В статье рассмотрены некоторые особенности острой хирургической патологии и осложнения, встречающиеся у пациентов с COVID-19. Особенности хирургической помощи в перепрофилированном стационаре — это строгое соблюдение эпидемиологического режима, минимизация численности персонала в операционной, возможная минимизация числа оперативных пособий и сокращение их длительности. Наиболее важной задачей в условиях пандемии COVID-19 является безопасность персонала.

Emergency surgery in the infectious diseases hospital is an urgent problem during the COVID-19 pandemic. Municipal Clinical Hospital No.15 named after O. M. Filatov has been providing emergency surgical care after conversion, from March 27, 2020 until now. The hospital’s medical staff has built up extensive experience: 194 surgical procedures were carried out in April, and 289 surgical procedures were carried out in May 2020. The paper reports the experience of emergency surgery at the stage of conversion to an infectious diseases hospital. Among all hospitalized patients, 482 (5.29%) people had acute surgical pathology requiring emergency surgery. Among patients who underwent urgent surgery, 472 (98%) people had the caused by COVID-19 community-acquired pneumonia of various degrees of severity. The paper discusses some features of acute surgical pathology and complications identified in patients with COVID-19. The surgical care features in the hospital after conversion are proper epidemiological regime implementation, minimization of the number of staff in the operating room, possible minimization of the number and reduction of the duration of surgical procedures. The most important challenge during the COVID-19 pandemic is medical staff safety.

No abstract

Introduction. Routine surgical care has been suspended during the COVID-19 pandemic. For the treatment of patients with acute cholecystitis, conservative treatment, percutaneous drainage of the gallbladder or cholecystectomy is offered. Tactics of treatment of patients with acute cholecystitis against the background of COVID-19 have not been studied. It is important to study the data concerning the time of cholecystectomy in acute cholecystitis, comparing “early” and “delayed” cholecystectomy, which is performed after a period of conservative therapy. Aim. To present and evaluate the results of treatment of patients with acute cholecystitis against the background of COVID-19 in the conditions of a repurposed multi-specialty hospital on the basis of the O. M. Filatov Clinic Hospital No. 15 in Moscow. Material and methods. A retrospective comparative study with history control included 16 patients with acute cholecystitis against the background of COVID-19. Mechanical jaundice syndrome was diagnosed in 3 (18.75%) patients. The diagnosis of coronavirus infection using PCR was confirmed in 5 patients, serological method-in 2 patients, and in 9 patients the diagnosis was confirmed by X-ray or CT examination with negative/doubtful PCR test results. Results. Nine (56.25%) patients were operated 4 (25%) percutaneous interventions were performed, in 3 (18.75%) cases conservative therapy was performed. Most patients were operated on within the first day of admission. In the main group, a fatal outcome occurred in 1 (6.25%) case (death from a thromboembolic complication in a patient with mechanical jaundice syndrome). Discussion. The choice of «early» cholecystectomy for acute cholecystitis, provided the condition is stable and the initial changes in the lungs are appropriate in most COVID-19 patients. Conclusion. Performing cholecystectomy in patients with coronavirus infection in an infectious hospital did not lead to an increase in the duration of inpatient treatment and the prevalence of complications. The approaches mentiobed in the results section can be used as a safe method in the discussed category of patients.

No abstract