Covid-19 and Colorectal Surgery: Lessons Learned From First Cases

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 SARS-CoV2 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.

Clinical outcomes of obstructive colorectal cancer patients during the coronavirus disease 2019 pandemic

“…The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of clinical care including diagnosis and treatment of colorectal cancers (CRCs) globally. [ 6 ] The first case of COVID-19 in Türkiye was reported on March 11, 2020 and the first government-imposed lockdown was announced on March 21, 2020. During the initial peak of the pandemic, elective surgeries and outpatient clinics were restricted in addition to the government-imposed lockdown.…”

“…Many of the in-patient wards, including surgical units, were converted to pandemic wards. [ 6 , 7 ] At that time, it was understood that COVID-19 could not be contained within a short-time frame, elective wards could only be opened on April 21, 2020. This resulted in a decrease in the number of patients seen in the outpatient clinic, colonoscopies being performed, and in-patient admissions for colorectal cancer during the pandemic.…”

“…[4,5] The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of clinical care including diagnosis and treatment of colorectal cancers (CRCs) globally. [6] The first case of COVID-19 in Türkiye was reported on March 11, 2020 ORIGINAL ARTICLE…”