How to safely perform surgery during COVID-19 pandemic: Study

A recent study by researchers from Turkey brought out that patients with gastrointestinal cancer should be operated on in pandemic hospitals under sufficient circumstances to avoid the repercussions of delayed treatment. The statistical findings were published online in the Journal of Surgical Oncology on 19 August 2021.

The purpose of this study was to evaluate the results of gastrointestinal cancer surgery patients and to offer patient care guidelines for resuming surgical therapy during the continuing COVID-19 pandemic while taking hospital facilities into consideration.

This study comprised 129 gastrointestinal cancer patients who had surgery between March 2020 and May 2021 at gastrointestinal surgery clinic at Erzurum Region Education and Research Hospital. It was designated a pandemic hospital in March 2020. The demographic features of the patients, as well as their preoperative and postoperative results, were clearly documented.

The hospital dedicated a 13-room, 26-bed ward and a 7-room ICU for cancer surgeries and waited for at least 5 days after admission to perform surgery and they tested for COVID-19 with PCR and thoracic and abdominal CT scans.

During their hospital stay, 8 individuals tested positive for COVID-19 (2 on admission, 6 during a preoperative PCR test). Seven patients were treated at the infection clinic and their surgeries were postponed. 1 had to have emergency surgery for obstructive colon cancer.

No patients became infected with COVID-19 while in postoperative critical care or after being transferred to the floor unit.

In conclusion of this study, the PI pointed out that failure to treat patients with gastrointestinal cancer during the pandemic may result in unfavorable outcomes such as stage shift and death. Cancer patients can be safely treated with conventional and minimally invasive surgery if current advice and experience are followed.

The surgical recommendations according to observation of researchers include:

1. CO2 filters in laparoscopy or robotic surgery;

2. Minimization of port site incisions,

3. Minimizing use of monopolar cautery, ultrasonic dissectors, and advanced bipolar devices,

4. Employing devices with attached smoke evacuators.

For further reading

Özdemir, Y., & Temiz, A. (2021). Surgical treatment of gastrointestinal tumors in a COVID‐19 pandemic hospital: Can open versus minimally invasive surgery be safely performed? Journal of Surgical Oncology. https://doi.org/10.1002/js