Laparoscopic surgery and coronavirus disease: What do we know now?

Ribeiro, Sofia; Lauletta, Ana Luisa F.; Franco, Beatriz Couto; Bezerra, Renata L Araujo; Vanni, D.G.B.S.; Baracat, Edmund C.

doi:10.6061/clinics/2020/e2083

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…First, we avoided the laparoscopic approach due to the theoretical risk of aerosolization, but we abandoned this practice because of the lack of strong evidence against the known benefits of minimally invasive surgery, such as earlier hospital discharge ( 13 , 14 ). To protect the staff, the number of surgical team members was kept to a minimum, and use of personal protective equipment was made mandatory, which included N-95 masks, waterproof surgical gown, and eye protection.…”

Section: Discussionmentioning

confidence: 99%

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Sobrado¹,

Nahas²,

Marques³

et al. 2021

Clinics

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Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. METHODS: This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. RESULTS: A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (po0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versus 10.3 days, respectively, po0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). CONCLUSION: Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.

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Section: Discussionmentioning

confidence: 99%

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Sobrado¹,

Nahas²,

Marques³

et al. 2021

Clinics

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show abstract

“…It was caused by a new coronavirus, which was named “SARS-CoV-2” by the World Health Organization (WHO) on February 13, 2020 ( 1 ). Meanwhile, the infectious disease caused by SARS-CoV-2 was named “COVID-19.” In China, according to the National Health Commission ( 2 ), a total of 82,341 cases were diagnosed, of which 77,892 patients were discharged, and 3,342 died as of April 15. Since the early stages of the outbreak, the disease has spread to most countries in the world.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Risk Factors for Mortality in Adult COVID-19 Patients in Wuhan: A Multicenter Study

Zeng

Chen

et al. 2020

Front. Med.

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Objectives: An outbreak of coronavirus disease (COVID-19) in 2019 in Wuhan, China, has spread quickly worldwide. However, the risk factors associated with COVID-19-related mortality remain controversial. Methods: A total of 245 adult patients with laboratory-confirmed COVID-19 from two centers were analyzed. Chi-square, Fisher's exact, and the Mann-Whitney U-tests were used to compare the clinical characteristics between the survivors and non-survivors. To explore the risk factors associated with in-hospital death, univariable and multivariable cox regression analyses were used. Results: Of the 245 patients included in this study, 23 (9.4%) died in the hospital. The multivariate regression analysis showed increased odds of in-hospital deaths associated with age, D-dimer levels >1,000 ng/L, platelet count < 125, and higher serum creatinine levels. Conclusions: We identified risk factors that show significant association with mortality in adult COVID-19 patients, and our findings provide valuable references for clinicians to identify high-risk patients with COVID-19 at an early stage.

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“…Several questions regarding the transmissibility of the COVID-19 remain unanswered [ 9 ]. During a pandemic period characterized by confused information, nonconsensual opinions, and scientific uncertainties [ 24 ], cases of endometriosis requiring more urgent surgery should be promptly identified and the benefits weighed against the risks on a case by case basis.…”

Section: Discussionmentioning

confidence: 99%

“…As our understanding of how the virus is transmitted and what protective equipment and procedures best protect healthcare workers and uninfected patients evolved in 2020, gynecologists at some hospitals and ambulatory surgical centers, including those at our institute, began to address the backlog of medically indicated procedures and surgeries [ 9 ]. The aim of this study is to share our experience with cases of women who presented in 2020 with endometriosis that was considered severe enough to warrant undergoing surgery, beginning five months after “social distancing” measures were instituted.…”

Section: Introductionmentioning

confidence: 99%

Endometriosis Surgery during the First Wave of the COVID-19 Pandemic: A Brazilian Single Institution Experience

Crispi¹,

Crispi²,

Nogueira

et al. 2021

Case Reports in Obstetrics and Gynecology

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Introduction. Early in the 2020 Coronavirus pandemic stay-at-home guidelines, there were public health orders that elective surgeries be deferred to prioritize hospital beds for critically ill COVID-19 patients. Besides, several reasons led to the postponement of consultations, diagnostic tests, and elective therapeutic procedures. As a result, some women with endometriosis faced chronification of their pain and decreased prospects for pregnancy. The aim of this study was to describe individual responses to minimally invasive complete excision of endometriosis through 40 days of follow-up of women whose endometriosis was considered severe enough to proceed with surgery during the fourth, fifth, and sixth months of constraints imposed by the pandemic. Preventive strategies and safety measures employed to protect patients and staff from acquiring or transmitting Coronavirus infection are presented. Case Presentation. This case series report enrolled 11 consecutive Brazilian women (ages 22 to 47 y) who underwent minimally invasive surgical treatment of endometriosis between June 26 and August 17, 2020. Cases of endometriosis requiring more urgent surgery were promptly identified and considered individually. The strict safety measures were well accepted by patients. No women developed any flu-like or COVID-19-related symptoms (cough, dyspnea, fever, or anosmia) in the 40 days of postoperative follow-up. One of the most praised measures reported by patients was the routine testing of the patient, the person who would accompany her in the hospital, and all medical staff and employees. Discussion. It is feasible to safely perform elective endometriosis surgery in selected cases during a pandemic.

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Laparoscopic surgery and coronavirus disease: What do we know now?

Cited by 6 publications

References 9 publications

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Analysis of the Risk Factors for Mortality in Adult COVID-19 Patients in Wuhan: A Multicenter Study

Endometriosis Surgery during the First Wave of the COVID-19 Pandemic: A Brazilian Single Institution Experience

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