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新冠疫情期间的外科手术活动:法国一家三级保健中心的 112 例患者结果,一项质量改进研究。

Surgical activity during the Covid-19 pandemic: Results for 112 patients in a French tertiary care center, a quality improvement study.

机构信息

Head and Neck Department, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon 1 University 103 Grande Rue de La Croix-Rousse, 69004, Lyon, France.

Gynecology and Obstetrics Department, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon 1 University 103 Grande Rue de La Croix-Rousse, 69004, Lyon, France.

出版信息

Int J Surg. 2020 Aug;80:194-201. doi: 10.1016/j.ijsu.2020.07.023. Epub 2020 Jul 18.

Abstract

BACKGROUND

After the emergence of Covid-19 in China, Hubei Province, the epidemic quickly spread to Europe. France was quickly hit and our institution was one of the first French university to receive patients infected with Sars-COV2. The predicted massive influx of patients motivated the cancellation of all elective surgical procedures planned to free hospitalization beds and to free intensive care beds. Nevertheless, we should properly select patients who will be canceled to avoid life-threatening. The retained surgical indications are surgical emergencies, oncologic surgery, and organ transplantation.

MATERIAL AND METHODS

We describe the organization of our institution which allows the continuation of these surgical activities while limiting the exposure of our patients to the Sars Cov2.

RESULTS

After 4 weeks of implementation of intra-hospital protocols for the control of the Covid-19 epidemic, 112 patients were operated on (104 oncology or emergency surgeries and 8 liver transplants). Only one case of post-operative contamination was observed. No mortality related to Covid-19 was noted. No cases of contamination of surgical care personnel have been reported.

CONCLUSION

We found that the performance of oncological or emergency surgery is possible, safe for both patients and caregivers.

摘要

背景

在中国出现新冠疫情后,湖北省的疫情迅速蔓延至欧洲。法国很快受到影响,我们所在的机构成为最早接收感染 SARS-CoV-2 病毒的法国大学之一。预计大量患者的涌入促使取消所有计划中的择期手术,以腾出住院床位和重症监护床位。然而,我们应该适当选择取消手术的患者,以避免危及生命。保留的手术指征为外科急症、肿瘤外科和器官移植。

材料与方法

我们描述了我们机构的组织形式,该形式允许在限制患者暴露于 SARS-CoV2 的情况下继续进行这些外科手术。

结果

在实施院内新冠疫情防控方案 4 周后,我们对 112 名患者进行了手术(104 例肿瘤或急症手术和 8 例肝移植)。仅观察到 1 例术后感染。未发现与新冠病毒相关的死亡病例。也未报告手术医护人员感染的情况。

结论

我们发现进行肿瘤或急症手术是可行的,对患者和医护人员都安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76ba/7368406/af30eca11edf/gr1_lrg.jpg

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