Background - In December 2019 following an outbreak of Novel coronavirus infection (COVID-19) in Wuhan, China, it spread rapidly overwhelming the healthcare systems globally. With little knowledge of COVID-19 virus, very few published reports on surgical outcomes; hospitals stopped elective surgery, whilst emergency surgery was offered only after exhausting all conservative treatment modalities. This study presents our experience of outcomes of emergency appendectomies performed during the pandemic. Methods – Prospectively we collected data on 132 patients in peak pandemic period from 1st March to 5th June 2020 and data compared with 206 patients operated in similar period in 2019. Patient demographics, presenting symptoms, pre-operative events, investigations, surgical management, postoperative outcomes and complications were analysed. Results – Demographics and ASA grades of both cohorts were comparable. In study cohort 84.4% and 96.7% in control cohort had laparoscopic appendicectomy. Whilst the study cohort had 13.6% primary open operations, control cohort had 5.3%. Mean length of stay and early post-operative complications (<30 days) were similar in both cohorts apart from surgical site infections (p = 0.02) and one mortality in study cohort. Conclusion – In these overwhelming pandemic times, although conservative treatment of acute appendicitis is an option, a proportion of patients will need surgery. Our study shows that with careful planning and strict theatre protocols, emergency appendicectomy can be safely offered with minimal risk of spreading COVID-19 infection. These observations warrant further prospective randomised studies. Keywords - appendicectomy, COVID-19, Coronavirus, emergency surgery, laparoscopy
COVID-19 pandemic has impacted health care globally with restructuring and prioritization of health care services. We prospectively analyzed 104 patients who underwent laparoscopic cholecystectomy during the peak of COVID-19 in 2020 and compared with 217 patients from the same period in 2019. Emergency admissions constituted majority of cases with no statistical difference between both groups (p = 0.49). Most cholecystectomies were for biliary colic (41.3 vs. 35.5%) and cholecystitis (37.5 vs. 43.8%) without any statistically difference (p = 0.31 and p = 0.29, respectively). This study demonstrates that laparoscopic cholecystectomy was feasible and safe in patients with symptomatic gall bladder disease during the peak period for COVID-19.
Introduction In March 2020, the World Health Organisation declared a global pandemic with the outbreak of a novel coronavirus. As the morbidity and mortality rates increased, the healthcare system was burdened with grave challenges including decisions on how to manage patients who needed emergency surgery during the pandemic. In the absence of clear guidelines and undetermined effects of peri-operative COVID-19 infection on surgical patient outcomes; our aim was to publish our surgical outcomes for emergency appendicentomies done during the pandemic. Method Prospective data was collated from 1st of March to 5th of June 2020 (n = 132) had appendicectomies over the period stated. Patient demographics, presenting symptoms, peri-operative events, investigations, and post-operative results and complications were documented and analysed. The results were then compared with outcomes of retrospective analysis at the same centre (n = 206) carried out from 1st March to 30th June 2019. Results The incidence of complications of appendicitis were similar without any significant differences. The negative appendix rate was significantly lesser in 2020 group, which may correlate to strict patient selection criteria for surgery. Conclusions Under strict selection protocols to reduce transmission of COVID- 19 and best surgical practice emergency appendicectomy is safe and feasible. However these observations warrant further well-designed future studies.
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