How can surgical continuity be maintained during the COVID-19 pandemic? A quality improvement study in the pre-vaccination period
Erol Pişkin1, Muhammet Kadri Çolakoglu1, Volkan Öter1, Yiğit Mehmet Özgün1, Osman Aydın1, Alper Güven1, Aziz Ahmet Sürel2, M. Mahir Özmen3,4,5, Erdal Birol Bostancı1
1Clinic of Gastrointestinal Surgery, Health of Sciences University Ankara City Hospital, Ankara, Turkey
2Clinic of General Surgery, Health of Sciences University Ankara City Hospital, Ankara, Turkey
3Department of Surgery, Medical School, Istinye University, Istanbul, Turkey
4General Surgery, Liv Hospital, Ankara, Turkey
5General Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey
Objective: During the COVID-19 pandemic, most of the elective surgeries had to be postponed. However, it is not possible to delay the surgical treat- ment of cancer patients for a long time. The aim of this study was to present how gastrointestinal system surgery operations are managed without delay and how employee safety is ensured , together with the results of the last five months. For this purpose, a preclinical and clinical screening system was created.
Material and Methods: Data of the patients who presented to our outpatient clinic between April 1st 2020 and August 31st 2020 were retrospectively reviewed.
Results: During the last five months of the pandemic, a total of 387 patients were hospitalized and 309 of these patients underwent surgical procedures. 165 of the patients who underwent surgery were newly diagnosed malignancy patients. All patients who were hospitalized were subjected to a screening for COVID-19 during the preclinical, clinical and surgical period. In the preclinical period, five patients were found positive and were directed to COVID-19 treatment without hospitalization. In the clinical period, six patients were isolated by showing symptoms during the hospitalization period. Only one of these patients received surgical treatment. The remaining five patients underwent endoscopic and interventional procedures. In this process, COVID-19 positivity was detected in a total of five healthcare workers.
Conclusion: With this preclinical and clinical screening method, it is shown that a COVID-19 sterile environment can be provided by early detection of positive cases in both patients and healthcare workers. In this way, the possibility of surgical continuity was demonstrated.
Keywords: COVID-19, pandemic, pre-vaccination period, surgery