Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, China.
Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMC Gastroenterol. 2020 Aug 14;20(1):269. doi: 10.1186/s12876-020-01411-y.
Cancer patients are at increased risk of novel coronavirus disease 2019 (COVID-19). Currently, surgeries for cancer patients with COVID-19 are generally suggested to be properly delayed.
We presented a 69-year-old Chinese female colon cancer patient with COVID-19, the first case accepted the surgical treatment during the pandemic in China. The patient developed a fever on January 28, 2020. After treatments with Ceftriaxone and Abidol, her fever was not moderated yet. A repeat chest computed tomography (CT) scan showed significantly exacerbated infectious lesions with a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid. An abdomen CT scan indicated the tumor of ascending colon with local wrapped changes. She was diagnosed with 'Severe novel coronavirus pneumonia' and 'Incomplete bowel obstruction: Colon cancer?'. After actively anti-inflammatory and anti-viral therapies, a right colectomy with lymph node dissection was performed on March 11, followed by a pathological examination. The patient successfully recovered from COVID-19 pneumonia and incomplete bowel obstruction after surgery without any postoperative related complications and was discharged on the 9th day after operation. Significant degeneration, necrosis and slough of focal intestinal and colonic mucosal epithelial cells were observed under microscope. No surgeons, nurses or anesthetists in our team were infected with SARS-CoV-2.
It is meaningful and imperative to share our experience of protecting health care personnels from SARS-CoV-2 infection and providing references for optimizing treatment of cancer patients, at least for the operative intervention with absolute necessity or surgical emergency, during the outbreak of COVID-19.
癌症患者罹患 2019 年新型冠状病毒病（COVID-19）的风险增加。目前，一般建议对 COVID-19 癌症患者的手术进行适当延迟。
我们报告了一例 COVID-19 合并结肠癌的 69 岁中国女性患者，这是中国大流行期间首例接受手术治疗的病例。患者于 2020 年 1 月 28 日出现发热，先后使用头孢曲松和阿比多尔治疗，但未见体温下降。复查胸部 CT 提示感染病灶明显加重，且 SARS-CoV-2 核酸检测阳性。腹部 CT 提示升结肠癌并局部包裹性改变，诊断为“重型新型冠状病毒肺炎，不完全性肠梗阻：结肠癌？”。经积极的抗炎和抗病毒治疗后，于 2020 年 3 月 11 日行右半结肠切除术+淋巴结清扫术，术后行病理检查。患者术后成功治愈 COVID-19 肺炎和不完全性肠梗阻，无术后相关并发症，术后第 9 天出院。镜下可见局部肠、结肠黏膜上皮细胞灶性变性、坏死、脱落。我们团队的外科医生、护士和麻醉师均未感染 SARS-CoV-2。
在 COVID-19 大流行期间，分享我们保护医护人员免受 SARS-CoV-2 感染的经验，并为优化癌症患者的治疗提供参考，对于绝对必要或紧急手术的干预措施，是有意义且迫切的。
