Thoracic surgery in a hospital dedicated to treating COVID-19: challenges and solutions

Mariani, Alessandro Wasum; Pêgo-Fernandes, Paulo Manuel

doi:10.6061/clinics/2020/e1982

Cited by 3 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In all operations, the surgery team was protected from the amount of aerosol and the leakage of the patients was reduced physiologically [ 14 , 15 ]. Similarly, in the literature, it has been reported that exposure to viral load is lower with the HEPA filter double drain bottle technique [ 16 ]. Especially in this period, the application of negative pressure and ventilation in all operating rooms will minimize aerosol risk [ 17 ].…”

Section: Discussionmentioning

confidence: 89%

Thoracıc surgery experience from the largest pandemic hospital in Europe

et al. 2021

View full text Add to dashboard Cite

Background SARS-CoV-2 coronavirus disease 19 (COVID-19), which was detected in December 2019, whose first cases were observed in Turkey on 11 th March 2020, and which was declared a pandemic by the World Health Organization on the same day, has become a public health problem worldwide and has required the adaptation of medical practices to the current situation. In the current paper, we present our experience and practices regarding thoracic surgery from the largest pandemic hospital in Europe over the 1-year period of the pandemic. Methods Patients who were operated by our thoracic surgery clinic in the largest pandemic hospital in Europe between March 2020 and March 2021 in the COVID-19 pandemic in our country and in the world were evaluated retrospectively. Results Eighty-five patients were operated on during the 1-year pandemic, of which 54 (63.5%) were men and 31 (36.5%) were women. The mean patient age was 47.7. Morbidity rate was 12%. The average number of PCR tests performed in the preoperative period for COVID-19 disease was 1.6. Sixteen patients had a history of COVID-19 before surgery. COVID-19 was not seen in any patient in our clinic during the postoperative period. Only one patient died out of those who underwent surgery. That patient died due to multiorgan failure. Conclusion Thoracic surgery has one of the highest risks due to direct contact with the lungs, especially in terms of surgery and the postoperative period. We consider that this risk will be minimized by taking measures during all processes. Moreover, we think that surgical treatments should be delayed as little as possible due to the special status of oncology patients. In addition, considering that if all these rules are followed in the COVID-19 pandemic and in other types of pandemics that may occur in the future, there will be no delay or insufficiency in the treatment of patients and healthcare professionals will be able to work safely.

show abstract

Section: Discussionmentioning

confidence: 89%

Thoracıc surgery experience from the largest pandemic hospital in Europe

et al. 2021

View full text Add to dashboard Cite

show abstract

“…For the most part, simple interventions as tracheostomy, chest tube insertion, and video-assisted thoracoscopic surgery for hemothorax or pleural empyema are reported. [5][6][7] Therefore, we wanted to share our experience with nonelective major thoracic surgery in COVID-19 patients under ongoing ECMO therapy. The Dresden ECMO Center is a major ECMO provider in East Germany for many years and has extensive experience with the application of ECMO for ARDS in non-COVID-19 cases.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to team safety, personal protective equipment (PPE) was routinely used at the ICU as well as in the operating room 5 (►Fig. 2).…”

Section: Team Safety In the Operating Roommentioning

confidence: 99%

“…By now several case series covering mostly minor operative interventions for conditions such as pneumothorax, pleural empyema, and hemothorax were reported. [5][6][7] In contrast, there is hardly any knowledge about the results of anatomical lung resections in COVID-19 patients put on ECMO. To fill this gap, we decided to report our experience with major thoracic surgery in COVID-19 patients while on ECMO.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of Emergency Pulmonary Lobectomy under ECMO Support in Patients with COVID-19

Almeida

Schweigert

Spieth

et al. 2023

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background Not much is known about the results of nonelective anatomical lung resections in coronavirus disease 2019 (COVID-19) patients put on extracorporeal membrane oxygenation (ECMO). The aim of this study was to analyze the outcome of lobectomy under ECMO support in patients with acute respiratory failure due to severe COVID-19. Methods All COVID-19 patients undergoing anatomical lung resection with ECMO support at a German university hospital were included into a prospective database. Study period was April 1, 2020, to April 30, 2021 (first, second, and third waves in Germany). Results A total of nine patients (median age 61 years, interquartile range 10 years) were included. There was virtually no preexisting comorbidity (median Charlson score of comorbidity 0.2). The mean interval between first positive COVID-19 test and surgery was 21.9 days. Clinical symptoms at the time of surgery were sepsis (nine of nine), respiratory failure (nine of nine), acute renal failure (five of nine), pleural empyema (five of nine), lung artery embolism (four of nine), and pneumothorax (two of nine). Mean intensive care unit (ICU) and ECMO days before surgery were 15.4 and 6, respectively. Indications for surgery were bacterial superinfection with lung abscess formation and progressive septic shock (seven of nine) and abscess formation with massive pulmonary hemorrhage into the abscess cavity (two of nine). All patients were under venovenous ECMO with femoral-jugular configuration. Operative procedures were lobectomy (eight) and pneumonectomy (one). Weaning from ECMO was successful in four of nine. In-hospital mortality was five of nine. Mean total ECMO days were 10.3 ± 6.2 and mean total ICU days were 27.7 ± 9.9. Mean length of stay was 28.7 ± 8.8 days. Conclusion Emergency surgery under ECMO support seems to open up a perspective for surgical source control in COVID-19 patients with bacterial superinfection and localized pulmonary abscess.

show abstract

“…Böylelikle hem oluşabilecek aerosol miktarından çalışanlar korunacak hem de hastanın kaçak miktarı fizyolojik yoldan azaltılacaktır. [14,15] Benzer şekilde yapılan çalışmalarda, HEPA filtreli çift dren şişesi tekniği ile de viral yüke daha az maruz kalındığı bildirilmiştir. [16] Ameliyat sonrası hastanın transferi esnasında da maskesinin mutlaka takılı olmasına özen gösterilmelidir.…”

Section: Ameliyat öNcesi Hazırlıkunclassified

What to Take Care About Thoracic Surgery Practice During COVID-19 Pandemic

Özer¹

2020

South Clin Ist Euras

View full text Add to dashboard Cite

Thoracic surgery in a hospital dedicated to treating COVID-19: challenges and solutions

Cited by 3 publications

References 1 publication

Thoracıc surgery experience from the largest pandemic hospital in Europe

Thoracıc surgery experience from the largest pandemic hospital in Europe

Outcome of Emergency Pulmonary Lobectomy under ECMO Support in Patients with COVID-19

What to Take Care About Thoracic Surgery Practice During COVID-19 Pandemic

Contact Info

Product

Resources

About