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Dorken-Gallastegi A, Argandykov D, Gebran A, Kaafarani HM. Surgical Implications of Coronavirus Disease-19. Gastroenterol Clin North Am 2023; 52:173-183. [PMID: 36813424 PMCID: PMC9537252 DOI: 10.1016/j.gtc.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
As the coronavirus disease-19 (COVID-19) pandemic continues to evolve in 2022 with the surge of novel viral variants, it is important for physicians to understand and appreciate the surgical implications of the pandemic. This review provides an overview of the implications of the ongoing COVID-19 pandemic on surgical care and provides recommendations for perioperative management. Most observational studies suggest a higher risk for patients undergoing surgery with COVID-19 compared with risk-adjusted non-COVID-19 patients.
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The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future. Indian J Surg 2022; 84:131-138. [PMID: 34149230 PMCID: PMC8197597 DOI: 10.1007/s12262-021-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and 'face-to-face' clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.
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The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies. Sci Rep 2021; 11:19645. [PMID: 34608197 PMCID: PMC8490421 DOI: 10.1038/s41598-021-98878-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 09/13/2021] [Indexed: 12/29/2022] Open
Abstract
Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP—appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.
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Gallo G, Ortenzi M, Grossi U, Di Tanna GL, Pata F, Guerrieri M, Sammarco G, Di Saverio S. What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review. World J Clin Cases 2021; 9:6759-6767. [PMID: 34447822 PMCID: PMC8362525 DOI: 10.12998/wjcc.v9.i23.6759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/15/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute colonic diverticulitis (ACD) is common in Western countries, with its prevalence increasing throughout the world. As a result of the coronavirus disease 2019 (COVID-19), elective surgery and in-patients’ visits have been cancelled or postponed worldwide.
AIM To systematically explore the impact of the pandemic in the management of ACD.
METHODS MEDLINE, Embase, Scopus, MedxRiv, and the Cochrane Library databases were searched to 22 December 2020. Studies which reported on the management of patients with ACD during the COVID-19 pandemic were eligible. For cross sectional studies, outcomes of interest included the number of hospital admission for ACD, as well as key features of disease severity (complicated or not) across two time periods (pre- and during lockdown).
RESULTS A total of 69 papers were inspected, and 21 were eligible for inclusion. Ten papers were cross sectional studies from seven world countries; six were case reports; three were qualitative studies, and two review articles. A 56% overall decrease in admissions for ACD was observed during lockdown, peaking 67% in the largest series. A 4%-8% decrease in the rate of uncomplicated diverticulitis was also noted during the lockdown phase. An initial non-operative management was recommended for complicated diverticulitis, and encouraged to an out-of-hospital regimen. Despite initial concerns on the use of laparoscopy for Hinchey 3 and 4 patients to avoid aerosolized contamination, societal bodies have progressively mitigated their initial recommendations as actual risks are yet to be ascertained.
CONCLUSION During the COVID-19 pandemic, fewer patients presented and were diagnosed with ACD. Such decline may have likely affected the spectrum of uncomplicated disease. Established outpatient management and follow up for selected cases may unburden healthcare resources in time of crisis.
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Affiliation(s)
- Gaetano Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro 88011, Italy
| | - Monica Ortenzi
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona 60121, Italy
| | - Ugo Grossi
- 2nd Surgery Unit, Regional Hospital Treviso, DISCOG, University of Padua, Treviso 31100, Italy
| | - Gian Luca Di Tanna
- The George Institute for Global Health, University of New South Wales, Sydney 2050, NSW, Australia
| | - Francesco Pata
- Department of General Surgery, Ospedale Nicola Giannettasio, Corigliano-Rossano 87064, Italy
- La Sapienza University, Roma 00185, Italy
| | - Mario Guerrieri
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona 60121, Italy
| | - Giuseppe Sammarco
- Department of Health Sciences, University "Magna Graecia" Medical School, University of Catanzaro, Catanzaro 88100, Italy
| | - Salomone Di Saverio
- Department of General Surgery, University of Insubria, University Hospital of Varese, Varese 21100, Italy
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Smith C, Habib Bedwani N, English W, Shatkar V. Comment on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option. Br J Surg 2021; 108:e50. [PMID: 33640915 PMCID: PMC7799352 DOI: 10.1093/bjs/znaa054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022]
Affiliation(s)
- C Smith
- Department of General Surgery, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK
| | - N Habib Bedwani
- Department of General Surgery, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK
| | - W English
- Department of General Surgery, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.,National Bowel Research Centre, Blizard Institute, QMUL, London, UK
| | - V Shatkar
- Department of General Surgery, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK
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Guadalajara H, Muñoz de Nova JL, Fernandez Gonzalez S, Yiasemidou M, Recarte Rico M, Juez LD, García Septiem J, Galindo Jara P, García Virosta M, Lobo Martínez E, Martín-Pérez E, García-Olmo D. Author response to: Comment on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option. Br J Surg 2021; 108:e42-e43. [PMID: 33640951 PMCID: PMC7929292 DOI: 10.1093/bjs/znaa022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/19/2020] [Indexed: 11/14/2022]
Affiliation(s)
- H Guadalajara
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - J L Muñoz de Nova
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - S Fernandez Gonzalez
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
| | - M Yiasemidou
- ST6 Colorectal Surgery, Leeds Teaching Hospitals, University of Hull, Hull, UK
| | - M Recarte Rico
- Department of General and Digestive Surgery, Tajo University Hospital, Madrid, Spain
| | - L D Juez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - J García Septiem
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - P Galindo Jara
- Department of General and Digestive Surgery, Torrejon University Hospital, Madrid, Spain
| | - M García Virosta
- Department of General and Digestive Surgery, Infanta Sofia University Hospital, Madrid, Spain
| | - E Lobo Martínez
- Department of General and Digestive Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - E Martín-Pérez
- Department of General and Digestive Surgery, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - D García-Olmo
- Department of General and Digestive Surgery, Fundación Jimenez Díaz University Hospital, Madrid, Spain
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Madrazo Z, Osorio J, Biondo S, Otero A, Videla S. Comments on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option. Br J Surg 2021; 108:e40-e41. [PMID: 33640954 PMCID: PMC7929193 DOI: 10.1093/bjs/znaa024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Z Madrazo
- Department of General and Digestive Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - J Osorio
- Department of General and Digestive Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - S Biondo
- Department of General and Digestive Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - A Otero
- Research Support Unit, Bellvitge Biomedical Research Institute, Department of Clinical Pharmacology, University of Barcelona, Barcelona, Spain
| | - S Videla
- Research Support Unit, Bellvitge Biomedical Research Institute, Department of Clinical Pharmacology, University of Barcelona, Barcelona, Spain
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Tur-Martínez J, Rodríguez-Santiago J. Comment on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option. Br J Surg 2021; 108:e39. [PMID: 33640953 PMCID: PMC7929105 DOI: 10.1093/bjs/znaa023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- J Tur-Martínez
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - J Rodríguez-Santiago
- Department of General Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
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