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Copyright (c) 2023 Cristian Antonio Pardo Munevar, Cinthya P. Castillo-Rodelo, Herney A. García-Perdomo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Reactivation of the elective surgical practice and prioritization strategies during SARS-CoV-2 pandemic: a successful experience
Corresponding Author(s) : Cristian Antonio Pardo Munevar
Ciencia e Innovación en Salud,
2023
Abstract
Objective: To describe the clinical/epidemiological characteristics and prioritization strategy in adult patients undergoing elective surgery during the SARS-CoV2 pandemic.
Method: Descriptive observational study of 297 surgical patients in a high complexity clinic in the city of Cali-Colombia, from April 27 to August 5, 2020. Four phases were established in the patients: Risk Stratification, Pre-surgical Strategy, Surgical Phase and Post-Surgical Follow-up.
Results: In the institution, 9 of the 20 authorized surgical services underwent surgical interventions during the study period. There were 21.9% of low severity complications (type I and II) according to Clavien-Dindo classification. A total of 189 oncologic (63%) and 108 non-oncologic (36%) procedures were performed. Risk stratification according to the MeNTS score was predominantly ≤50 (294 patients). Post-surgical follow-up was performed by telephone and face-to-face; only one patient presented symptoms suggestive of SARS-CoV2 infection.
Conclusion: During the resume of ambulatory surgical activities, strict protocols were established with defined criteria for the selection of patients undergoing surgical procedures and measures to minimize the risk of nosocomial SARS-CoV2 infection in patients and healthcare team personnel.
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- Dawood AA. Mutated COVID-19 may foretell a great risk for mankind in the future. New microbes new Infect. 2020 May;35:100673. DOI: 10.1016/j.nmni.2020.100673
- WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020 [Internet]. [cited 2021 Jul 18]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
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- Guo X, Wang J, Hu D, Wu L, Gu L, Wang Y, et al. Survey of COVID-19 Disease Among Orthopaedic Surgeons in Wuhan, People’s Republic of China. J Bone Joint Surg Am. 2020 May;102(10):847–54. DOI: 10.2106/jbjs.20.00417
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- Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020 Apr;21:100331. DOI: 10.1016/j.eclinm.2020.100331
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References
Dawood AA. Mutated COVID-19 may foretell a great risk for mankind in the future. New microbes new Infect. 2020 May;35:100673. DOI: 10.1016/j.nmni.2020.100673
WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020 [Internet]. [cited 2021 Jul 18]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020 Apr;76:71–6. https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-2395
Kissler SM, Tedijanto C, Goldstein E, Grad YH, Lipsitch M. Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period. Science. 2020 May;368(6493):860–8. DOI: 10.1126/science.abb5793
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N Engl J Med. 2020;382(13):1199–207. https://www.nejm.org/doi/full/10.1056/nejmoa2001316
Barrios Parra A, Prieto Ortiz RG, Torregrosa Almonacid L, Álvarez Tamayo CA, Hernández-Restrepo JD, González Higuera LG, et al. Volver a empezar: cirugía electiva durante la pandemia del SARS-CoV2. Recomendaciones desde la Asociación Colombiana de Cirugía: . Rev Colomb Cirugía [Internet]. 2020 May 11;35(2 SE-Guías):302–21. Available from: DOI: 10.30944/20117582.656
Diaz-Pinzón, JE. Estimación de la prevalencia del COVID-19 en Colombia. Revista Repertorio de Medicina y Cirugía 2020: 99-102. DOI: 10.31260/RepertMedCir.01217372.1115
Martínez-Hernández NJ, Caballero Silva U, Cabañero Sánchez A, Campo-Cañaveral de la Cruz JL, Obeso Carillo A, Jarabo Sarceda JR, et al. Effect of COVID-19 on Thoracic Oncology Surgery in Spain: A Spanish Thoracic Surgery Society (SECT) Survey. Cancers (Basel). 2021 Jun;13(12). DOI: 10.3390/cancers13122897
Patt D, Gordan L, Diaz M, Okon T, Grady L, Harmison M, et al. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. JCO Clin cancer informatics. 2020 Nov;4:1059–71. DOI: 10.1200/cci.20.00134
Jarabo JR, Martínez N, Cabañero A, Call S, Campo-Cañaveral JL, Cilleruelo Á, et al. Recommendations for acting in elective and urgent thoracic surgery during SARS-CoV-2 pandemic. Spanish Society of Thoracic Surgery. Cir Esp. 2020 Dec;98(10):574–81. DOI: 10.1016/j.ciresp.2020.08.005
Depypere LP, Daddi N, Gooseman MR, Batirel HF, Brunelli Alessandro on behalf of the ELAC. The impact of coronavirus disease 2019 on the practice of thoracic oncology surgery: a survey of members of the European Society of Thoracic Surgeons (ESTS). Eur J Cardio-Thoracic Surg [Internet]. 2020;58(4):752–62. Available from: DOI: 10.1093/ejcts/ezaa284
Guo X, Wang J, Hu D, Wu L, Gu L, Wang Y, et al. Survey of COVID-19 Disease Among Orthopaedic Surgeons in Wuhan, People’s Republic of China. J Bone Joint Surg Am. 2020 May;102(10):847–54. DOI: 10.2106/jbjs.20.00417
Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 2020 May;369:m1642. DOI: 10.1136/bmj.m1642
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw open. 2020 Mar;3(3):e203976. DOI: 10.1001/jamanetworkopen.2020.3976
Ministerio de Salud y Protección Social. Resolucion Numero 5261. Act Interv y Procedimientos del Plan Oblig Salud en el Sist Gen Segur Soc en Salud [Internet]. 1994;1994(Agosto 5):1–138. Available from: https://www.minsalud.gov.co/Normatividad_Nuevo/RESOLUCIÓN 5261 DE 1994.pdf
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020 Apr;21:100331. DOI: 10.1016/j.eclinm.2020.100331
Li Y-K, Peng S, Li L-Q, Wang Q, Ping W, Zhang N, et al. Clinical and Transmission Characteristics of Covid-19 - A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department. Curr Med Sci. 2020 Apr;40(2):295–300. DOI: 10.1007%2Fs11596-020-2176-2
Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 2020 Aug;155(8):691–702. DOI: 10.1001/jamasurg.2020.2713
Molano-Caro J, Borrero-Cortés C, Lizarazo-Rodríguez J, Gómez-Chacón NE. Retorno a la actividad asistencial en el contexto de COVID-19: priorización, protocolos y procedimientos. Experiencia de una unidad de gastroenterología ambulatoria en Bogotá, Colombia . Rev colomb Gastr. scieloco ; 2020; 35. 287–97. DOI: 10.22516/25007440.598