Is it too premature to recommend against laparoscopic emergency surgery in COVID-19 patients?

Yeo, Chia Rou; Yeo, Danson; Sanghvi, Kaushal; Ahmed, Saleem

doi:10.1002/bjs.11668

Cited by 10 publications

(10 citation statements)

References 5 publications

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“…According to a serological study about immunity against COVID developed by the Spanish Government, 11.4% of Madrid population have immunoglobulins against COVID [12], which could represent over 600.000 cases. The effect of COVID pandemic on emergency surgery has been a subject of analysis in several studies [13][14][15][16]. The results of the PIACO study are consistent with other studies in the current literature.…”

Section: Change In Epidemiological Patternsupporting

confidence: 79%

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Guadalajara

Nova

Gonzalez

et al. 2020

Preprint

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BackgroundAnecdotal 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. MethodsThis was a multicentre, comparative study, whereby ASIP cases from March 14th to May 2nd 2019 acted as historical controls for the cohort of patients with the same pathology during the COVID-19 pandemic. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain).ResultsThe number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020. This reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. ConclusionsThe number of ASIP cases treated during the pandemic was reduced by more than one third mainly due to a dramatic reduction in mild cases. This also has represented a selection of severe cases. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances.The positive COVID-19 status itself did not have a direct impact on either morbidity or mortality. 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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Section: Change In Epidemiological Patternsupporting

confidence: 79%

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Guadalajara

Nova

Gonzalez

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite early recommendations against minimally invasive surgery [ 6 – 11 , 22 – 24 ], there is little evidence regarding the aerosolization potential of laparoscopy and its effects on surgeon’s safety. The more recent policy is one of business-as-usual, with measures taken to minimize the free release of insufflated gas [ 25 , 26 ]. This is the policy we have adhered to since the beginning of the pandemic, maintaining the usual overall rate of close to 80% of laparoscopic approach at our EGS Unit.…”

Section: Discussionmentioning

confidence: 99%

Overall management of emergency general surgery patients during the surge of the COVID-19 pandemic: an analysis of procedures and outcomes from a teaching hospital at the worst hit area in Spain

Fernández-Martínez

Román

Luz

et al. 2021

Eur J Trauma Emerg Surg

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“…Despite early recommendations against minimally invasive surgery [14,15], there is little evidence about laparoscopy's aerosolization potential and thus virus dissemination. The most recent policy is to minimize the free release of insu ated gas [16,17].This is the policy that we have adhered to since the beginning of the pandemic, maintaining the usual overall rate of laparoscopic surgeries in patients admitted from the SED while adhering to proposed international surgical practice guidelines and directives [18].…”

Section: Discussionmentioning

confidence: 99%

The Effect of the COVID Pandemic Lockdown Measures on Surgical Emergencies: Experience and Lessons Learned from A Greek Tertiary Hospital.

Pikoulis

Koliakos

Papaconstantinou

et al. 2021

Preprint

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Background: The COVID-19 pandemic caused a rise in healthcare demands and has necessitated a significant restructuring of hospital Emergency Departments.The present study aims to determine the pandemic lockdown's impact on the number of patients seeking assessment in the Surgical Emergency Department (SED) with General Surgery emergencies. Methods: Since the start of the Covid pandemic in Greece (1 March, 2020) and up to 15 December 2020, the charts of all patients arriving at the SED of the third surgical department of the “Attikon” University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A; 1/3/2020 to 30/4/2020 and period D; 16/10/2020 to 15/12/2020) and two interim (period B; 1/5/2020 to 15/6/2020 and period C; 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019.Results:The total number of patients attending the SED decreased by 35.9% during the pandemic (from 2839 total patients in 2020 to 1819 in 2019). During the first lockdown, there was a statistically significant reduction of motor vehicle accidents (p=0.04) and torso injuries (p=0.01). A rise in the rate of traumatic brain injuries (p<0.001), abdominal pain (p=0.04) and hospital admissions (p=0.002) was also evident. During the second lockdown, there was a reduction in the number of perianal abscess cases (p=0.04) and hernia-related problems (p=0.001). An increase in the rate of fall injuries was also demonstrable (p=0.02).Conclusion: The burden of the new COVID-19 disease has left a noticeable imprint in the function of emergency departments worldwide. In Greece, implemented lockdown measures significantly impacted the SED attendance rates, the clinical characteristics of the attending patients and the overall hospital admission rate. The long-term effects on national health systems remain to be seen.

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Is it too premature to recommend against laparoscopic emergency surgery in COVID-19 patients?

Cited by 10 publications

References 5 publications

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Overall management of emergency general surgery patients during the surge of the COVID-19 pandemic: an analysis of procedures and outcomes from a teaching hospital at the worst hit area in Spain

The Effect of the COVID Pandemic Lockdown Measures on Surgical Emergencies: Experience and Lessons Learned from A Greek Tertiary Hospital.

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