COVID 19 in phase 2 sustained. Initial surgical experience at the Maciel Hospital
DOI:
https://doi.org/10.31837/cir.urug.4.2.6Keywords:
COVID 19, surgery, epidemiology, UruguayAbstract
Introduction. In Uruguay, the start of the pandemic was decreed by Covid. 19 on March 13, 2020, In this context, the Maciel Hospital (HM) established guidelines and recommendations to face the disease that radically modified its usual benefits. The objective of this communication is to present the surgical experience developed in the care context of a sustained phase 2 of Covid infection.19 Material and methods The surgical activity of the HM is retrospectively analyzed from its record of Operative Descriptions, during the period between 13.3.2020 and 30.4.2020 (49 days) and performs a critical analysis from the governing documents of our surgical conduct. Results: 403 cases, 149 coordination and 254 emergency were operated. 287 patients with multiple etiologies, although predominantly oncological (27%) and infectious / inflammatory processes (19%), were operated by the general and specialty surgery services. Laparoscopy involved 62 cases, 43 of which were urgent, mostly due to infectious / inflammatory pathologies: appendicitis (35%), cholecystectomies (24%), and diagnostic laparoscopies (11%). 55% of the cases underwent surgery for cancer and the rest cholecystectomies and others. Conclusions: The HM operated three times more than the rest of the public system; Even so, with respect to its usual production, the number of surgeries decreased significantly (35%), especially coordination (59%). Covid.19 positive patients were not operated. A high number of justified operations were carried out in terms of quantity and type of pathology, using the protocol for maximum protection against Covid.19 rationally, within the established sanitary guidelines and without infectious impact by the coronavirus
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2) Cebriá AL., Sosa Carreras G., Blanco Amaral A., Canessa C. Protocolo para paciente con COVID -19 que ingresan a Block Quirúrgico. ASSE. Hospital Español. Marzo 13.2020
3) Plan Nacional de Contingencia para la Infección (COVID-19) por el nuevo Coronavirus
(SARS CoV2). Ministerio Salud Pública. Versión 9.3.2020. [Consulta 3 de mayo 2020]. Disponible en. https://www.gub.uy/ministerio-salud-publica/comunicacion/publicaciones/plan-nacional-contingencia-para-infeccion-covid-19-nuevo-coronavirus
4) Comunicado Nº 12. Definiciones de caso confirmado y sospechoso y realización de hisopados. Comité de Contingencia Coronavirus. ASSE. 27.3.2020
5) Protocolo de condiciones y medio ambiente de trabajo Medidas de protección del equipo de salud y usuarios del SNIS. Ministerio Salud Pública. 17.4.2020. [Consulta 15 de abril de 2020]. Disponible en: https://www.gub.uy/ministerio-salud-publica/comunicacion/noticias/protocolo-sobre-medidas-proteccion-del-equipo-salud-usuarios-del-snis
6) Flujograma y pautas de asistencia a pacientes internados en el contexto de la Pandemia. SARS COV 2 . Hospital Maciel .Elaboradas 1/4/2020, modificadas 16/4/2020
7) Rodríguez., M. , Ruso Martínez, L. Camejo E. Protocolo para el Manejo de los pacientes
Covid.19 en sala de Operaciones. Hospital Maciel. Departamento de Cirugía. 24.4.2020.
8) Blanco. R. Declaración de emergencia sanitaria por la pandemia de (SARS-CoV-2) Impacto sobre la actividad quirúrgica en ASSE. Análisis de las primeras seis semanas. Comunicación personal. Mayo 2020.
9) Zhang S. What it really means to cancel elective surgeries: to make room for coronavirus patients, hospitals are delaying procedures that would make major differences in people’s lives. The Atlantic, March 17, 2020.12. [Consulta 16 de abril 2020]. Disponible en: https://www.theatlantic.com/science/archive/2020/03/patients-whose-surgeries-are-canceled-because-coronavirus/608176/
10) Perdomo M., Ruso Martínez L., Olivera Pertusso E. , Rodríguez Temesio G. , González D.
Práctica quirúrgica en Uruguay durante la Pandemia COVID-19. Análisis de aspectos cualitativos y cuantitativos de su fase inicial. [en prensa] Revista SCU. (Mayo 2020)
11) Stahel P. How to risk-stratify elective surgery during the COVID-19 pandemic?
Patient Saf Sur (2020) 14:8. https://doi.org/10.1186/s13037-020-00235-9
12) Beasley D. United States hospitals and patients cancel elective surgery as coronavirus spreads. The New York Times, March 16, 2020. [Consulta 30 de marzo 2020] Disponible en: https://www.reuters.com/article/us-health-coronavirus-usa-surgery/u-s-hospitals-patients-cancel-elective-surgery-as-coronavirus-spreads-idUSKBN2133SK
13) Balibrea JM. ,. Badia JM., , Rubio Perez I. , Mart?n Antona E. , Alvarez Pena,E. , Garc?a Botella S. , et al. Manejo quirúrgico de pacientes con infeccion por COVID-19. Recomendaciones de la Asociación Española de Cirujanos .Rev.Esp.Cir. 2020 : 98 ;251-259 . DOI: 10.1016/j.ciresp.2020.03.001
14) Francis N, Dort J, Cho E, Feldman L, Keller D, Lim R, SAGES and EAES recommendations
for minimally invasive surgery during COVID?19 pandemic.Surg Endosc. 2020; 1-5 .https://doi.org/10.1007/s00464-020-07565-w
15) Zheng MH , Boni L, Abe F. Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy. Ann Surg. 2020. 10.1097/SLA.0000000000003924. Published online 2020 Apr 23. Doi: 10.1097/SLA.0000000000003924c
16) Coccolini ,F., Tartaglia ,D., Puglisi,A., Giordano,C., Pistello,M., Lodato,M., Chiarugi ,M. SARS-CoV-2 is present in peritoneal fluid in COVID-19 patients. Ann. Surgery Mayo 2020. (Aceptado para publicación). Disponible en: https://journals.lww.com/annalsofsurgery/Documents/SARS-CoV-2%20is%20present%20in%20peritoneal%20fluid%20in%20COVID-19%20patients.pdf
17) Ngaserin, S.H., Koh, F.H., Ong, B. Chew MH. COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient.
Langenbecks Arch Surg (2020). May 9: 1-3.https://doi.org/10.1007/s00423-020-01891-2
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