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[2019年新型冠状病毒病疫情下中国结直肠癌的若干手术建议]

[Several suggestions of operation for colorectal cancer under the outbreak of corona virus disease 2019 in China].

作者信息

Yu G Y, Lou Z, Zhang W

机构信息

Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Mar 25;23(3):208-211. doi: 10.3760/cma.j.cn.441530-20200224-00074.

Abstract

Pneumonia caused by 2019-nCoV infection has been reported in Wuhan since December 2019, and spread rapidly across the country. The radical operation of colorectal cancer is semi-elective operation. Patients with colorectal cancer should receive operation as soon as possible after elective operation is resumed in each hospital. 2019-nCoV virus can be transmitted by asymptomatic infectors, and it has been confirmed to be transmitted by droplets and contact. However, fecal-oral transmission and aerosol transmission have not been excluded. Based on our experience with laparoscopic colorectal operation, we propose some surgery strategies for colorectal cancer patients under the corona virus disease 2019(COVID-19) situation: the screening process should be strictly carried out before surgery to reduce the risk of nosocomial infection in the later stage; laparoscopic-assisted surgery is recommended for radical surgery for patients with colorectal cancer; strict aerosol management must be made during the operation; natural orifice specimen extraction surgery and transanal total mesorectal excision are should be performed prudently; scientific and reasonable prophylactic stoma should be done; personnel protection in surgical ward and operation room must be strengthened.

摘要

自2019年12月以来,武汉报告了由2019新型冠状病毒感染引起的肺炎,并迅速在全国蔓延。结直肠癌根治术属于半择期手术。各医院恢复择期手术后,结直肠癌患者应尽快接受手术。2019新型冠状病毒可通过无症状感染者传播,已证实可通过飞沫和接触传播。然而,粪口传播和气溶胶传播尚未排除。基于我们的腹腔镜结直肠手术经验,我们提出了一些在2019冠状病毒病(COVID-19)情况下针对结直肠癌患者的手术策略:术前应严格进行筛查流程,以降低后期医院感染风险;对于结直肠癌患者的根治性手术,建议采用腹腔镜辅助手术;术中必须严格进行气溶胶管理;应谨慎进行经自然腔道标本取出手术和经肛全直肠系膜切除术;应进行科学合理且预防性的造口;必须加强手术病房和手术室的人员防护。

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