Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, 248001, Uttarakhand, India.
Department of Radiation Oncology, Swami Rama Himalayan University, Dehradun, India.
Clin J Gastroenterol. 2021 Aug;14(4):932-946. doi: 10.1007/s12328-021-01424-4. Epub 2021 Apr 29.
COVID-19 pandemic has brought a paradigm shift in the treatment of various surgical gastrointestinal disorders. Given the increasing number of patients requiring hospitalization and intensive care for SARS-CoV-2 infections, various surgical departments worldwide were forced to stop or postpone elective surgeries to save the health resources for COVID-19 patients. Since the declaration of the COVID-19 pandemic by the World Health Organization on 12th March 2020, the recommendations from the surgical societies kept evolving to help the surgeons in making informed decisions regarding patient care. Moreover, various socio-economic and epidemiological factors have come into play while deciding the optimal approach towards patients requiring gastrointestinal surgery. Surgeries for many abdominal diseases such as acute appendicitis and acute calculous cholecystitis were postponed. Elective surgeries were triaged based on the urgency of performing the surgical procedure, the hospital burden of COVID-19 patients, and the availability of healthcare resources. Various measures were adopted such as preoperative screening for SARS-CoV-2 infection, use of personal protective equipment, and the COVID-19-free surgical pathway to prevent perioperative SARS-CoV-2 transmission. In this article, we have reviewed the recent studies reporting the outcomes of various gastrointestinal surgeries in the COVID-19 pandemic era and the recommendations from various surgical societies on the safety precautions to be followed during gastrointestinal surgery.
COVID-19 大流行给各种外科胃肠道疾病的治疗带来了范式转变。由于需要住院和重症监护治疗 SARS-CoV-2 感染的患者数量不断增加,世界各地的各种外科部门被迫停止或推迟择期手术,以节省 COVID-19 患者的医疗资源。自 2020 年 3 月 12 日世界卫生组织宣布 COVID-19 大流行以来,外科协会的建议不断发展,以帮助外科医生就患者护理做出明智的决策。此外,在决定需要胃肠道手术的患者的最佳治疗方法时,各种社会经济和流行病学因素也发挥了作用。许多腹部疾病的手术,如急性阑尾炎和急性胆石性胆囊炎,都被推迟了。择期手术根据手术的紧迫性、COVID-19 患者的医院负担以及医疗保健资源的可用性进行分类。采取了各种措施,如对 SARS-CoV-2 感染进行术前筛查、使用个人防护设备以及 COVID-19 无手术途径,以防止围手术期 SARS-CoV-2 传播。本文综述了最近报道 COVID-19 大流行时代各种胃肠道手术结果的研究,以及各外科协会关于胃肠道手术期间应遵循的安全预防措施的建议。