COVID-19 PANDEMİSİNİN CERRAHİ HİZMETLERİN SUNULMASI ÜZERİNDEKİ ETKİLERİ

Yıl 2021, , 337 - 341, 24.12.2021

Kezban Koraş Sözen

https://doi.org/10.34108/eujhs.1040455

Öz

Dünyada ve ülkemizde etkisini gösteren Covid-19 pandemisi, milyonlarca hastaya cerrahi bakım verilmesini olumsuz yönde etkilemiştir. Pandemi yönetimi ve pandeminin cerrahi operasyonlar üzerindeki etkileri hakkında çok az bilgiye ulaşılabilmektedir. Kısa bir süre içinde birkaç perioperatif kılavuz yayınlanmıştır. Ancak pek çok öneri çelişkilidir ve deneyimlere dayanmaktadır. Cerrahi operasyonların sık yapıldığı bölgeler, aynı zamanda pandemiden en çok etkilenen bölgelerdir. Bu bölgelerde çok sayıda cerrahi operasyon iptal edilmek ya da ertelenmek zorunda kalmıştır. Pandeminin, cerrahi tedavinin doğası (anestezi kullanımı, ameliyathaneler, koruyucu ekipman ve perioperatif bakım ihtiyacı) nedeniyle, hastaları orantısız bir şekilde etkilemektedir. Postpandemik değerlendirme ve gelecek planlama, bir pandemi sırasında popülasyon için uygun cerrahi bakımı sürdürmenin önemli bir parçası olmalıdır. Postpandemik aşamada, cerrahi hizmetlerin yeniden normal haline dönmesi için pandemi sürecinde birikmiş vakaların, iş yükünü uygun bir şekilde azaltmak amacıyla mevcut kapasitenin geliştirilmesi gerekecektir. Bu derlemede, COVID-19 pandemisinin cerrahi hizmetlerin sunulması üzerindeki etkilerine yer verilmektedir.

Anahtar Kelimeler

Cerrahi hizmetler, COVID-19, pandemi.

THE EFFECTS OF COVID-19 PANDEMIA ON THE DELIVERY OF SURGICAL SERVICES

Öz

The Covid-19 pandemic, which is a global phenomenon, affected the provision of surgical care for millions of patients negatively. Little information is available on pandemic management and the effects of the pandemic on surgical operations. Several perioperative guidelines have been published over a short period of time. However, many recommendations are contradictory and based on experiences. The regions with a high number of surgical operations are also the regions most affected by the pandemic. Many surgical operations in these areas had to be canceled or postponed. Pandemic appears to affect patients disproportionately due to the nature of surgical treatment (the use of anesthesia, operating rooms, protective equipment, and the need for perioperative care). Post-pandemic assessment and future planning should be an important part of maintaining appropriate surgical care for the population during a pandemic. The post-pandemic phase will require reestablishment of surgical services and capacity building to restore normality and appropriately reduce the backlog of cases as a priority. This review highlights the effects of the COVID-19 pandemic on the delivery of surgical services.

Anahtar Kelimeler

Covid-19, pandemic, surgical services

Kaynakça

• Gök AFK, Eryılmaz M, Özmen MM, et al. Recommendations for trauma and emergency general surgery practice during COVID-19 pandemic. Ulus Travma Acil Cerrahi Derg 2020; 26:335-342.
• Argo JL, Vick CC, Graham LA, et al. Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement. Am J Surg 2009; 198:600-606.
• Cookson G, Jones S, Laliotis I. Cancelled procedures in the English NHS: evidence from the 2010 tariff reform. Health Econ 2017; 26: e126-e139.
• Al Talalwah N, McIltrot KH. Cancellation of surgeries: integrative review. J Perianesth Nurs 2019; 34: 86-96.
• Spinelli A, Pellino G. COVID‐19 pandemic: perspectives on an unfolding crisis. Br J Surg 2020; 107:785-787.
• Dexter F, Parra MC, Brown JR, Loftus RW. Perioperative COVID‐19 defense: an evidence‐based approach for optimization of infection control and operating room management. Anesth Analg 2020; 131:37-42.
• Greenland JR, Michelow MD, Wang L, London MJ. COVID‐19 infection: implications for perioperative and critical care physicians. Anesthesiology 2020; 132:1346-1361.
• Chen X, Liu Y, Gong Y, et al. Perioperative management of patients infected with the novel coronavirus: Recommendation from the Joint Task Force of the Chinese Society of Anesthesiology and the Chinese Association of Anesthesiologists. Anesthesiology 2020; 132:1307-1316.
• Aminian A, Safari S, Razeghian‐Jahromi A, Ghorbani M, Delaney CP. COVID‐19 outbreak and surgical practice: unexpected fatality in perioperative period. Ann Surg 2020; 272:27-29.
• Brat GA, Hersey SP, Chhabra K, Gupta A, Scott J. Protecting surgical teams during the COVID‐19 outbreak: a narrative review and clinical considerations. Ann Surg 2020; doi: 10.1097/SLA.0000000000003926.
• Brindle M, Gawande A. Managing COVID‐19 in surgical systems. Ann Surg 2020; 272:e1-e2. doi: 10.1097/SLA.0000000000003923.
• WHO. Coronavirus Disease (COVID‐19) Technical Guidance: Maintaining Essential Health Services and Systems https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems; Accessed date: 02 November 2020.
• Gagliano A, Villani PG, Co FM, et al. COVID‐19 epidemic in the middle province of northern Italy: impact, logistics, and strategy in the first line hospital. Disaster Med Public Health Prep 2020; doi: 10.1017/dmp.2020.51.
• Iacobucci G. Covid‐19: all non‐urgent elective surgery is suspended for at least three months in England. BMJ 2020; 368:m1106. doi: 10.1136/bmj.m1106.
• Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID‐19 infection. EClinicalMedicine 2020; doi: 10.1016/j.eclinm.2020.100331.
• Augestad KM, Sneve AM, Lindsetmo RO. Telemedicine in postoperative follow‐up of STOMa PAtients: a randomized clinical trial (the STOMPA trial). Br J Surg 2020; 107:509-518.
• Türkmen E. COVID-19 Salgınında yoğun bakım ünitelerinin organizasyonu. Yoğun Bakım Hemşireliği Dergisi 2020; 24(EK-1):39-45.
• Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020; 67:568-576.
• Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid‐19. N Engl J Med 2020; 382:1679-1681.
• Kulkarni SS, Briggs A, Sacks OA, et al. Inner deliberations of surgeons treating critically‐ill emergency general surgery patients: a qualitative analysis. Ann Surg 2019; doi: 10.1097/SLA.0000000000003669.
• Emanuel EJ, Persad G, Upshur R, et al. Fair allocation of scarce medical resources in the time of Covid‐19. N Engl J Med 2020; 382:2049-2055.
• Rosenbaum L. Facing Covid‐19 in Italy-ethics, logistics, and therapeutics on the epidemic's front line. N Engl J Med 2020; 382:1873-1875.
• Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID‐19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395:1054-1062.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497-506.
• Guan WJ, Ni ZY, Hu Y, et al. China Medical Treatment Expert Group for Covid‐19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382:1708-1720.
• Luo S, Zhang X, Xu H. Don't overlook digestive symptoms in patients with 2019 novel coronavirus disease (COVID‐19). Clin Gastroenterol Hepatol 2020; 18: 1636-1637.
• Wong SH, Lui RN, Sung JJ. Covid‐19 and the digestive system. J Gastroenterol Hepatol 2020; doi: 10.1111/jgh.15047.
• Liang W, Feng Z, Rao S, et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut 2020; doi: 10.1136/gutjnl-2020-320832.
• Zhou Z, Zhao N, Shu Y, et al. Effect of gastrointestinal symptoms on patients infected with COVID‐19. Gastroenterology 2020; 158:2294-2297.
• Mao L, Wang M, Chen S, et al. Neurological manifestations of hospitalized patients with COVID‐19 in Wuhan, China: a retrospective case series study. medRxiv 2020; doi: 10.1101/2020.02.22.20026500.
• Bagheri SHR, Asghari AM, Farhadi M, et al. Coincidence of COVID‐19 epidemic and olfactory dysfunction outbreak. medRxiv 2020; doi: 10.1101/2020.03.23.20041889.
• Han H, Yang L, Liu R, et al. Prominent changes in blood coagulation of patients with SARS‐CoV‐2 infection. Clin Chem Lab Med 2020; 58:1116-1120.
• Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with COVID‐19 in Wuhan, China. Clin Infect Dis 2020; 71:762-768.
• Wang T, Du Z, Zhu F, et al. Comorbidities and multi‐organ injuries in the treatment of COVID‐19. Lancet 2020; 395(10228):e52. doi: 10.1016/S0140-6736(20)30558-4.
• Liew MF, Siow WT, Yau YW, See KC. Safe patient transport for COVID‐19. Crit Care 2020; 24:94.
• Zhao S, Ling K, Yan H, et al. Anesthetic management of patients with COVID 19 infections during emergency procedures. J Cardiothorac Vasc Anesth 2020; 34: 1125-1131.
• Kumar D, Manuel O, Natori Y, et al. COVID‐19: a global transplant perspective on successfully navigating a pandemic. Am J Transplant 2020; doi: 10.1111/ajt.15876.
• Michaels MG, La Hoz RM, Danziger‐Isakov L, et al. Coronavirus disease 2019: implications of emerging infections for transplantation. Am J Transplant 2020; doi: 10.1111/ajt.15832.
• Gori A, Dondossola D, Antonelli B, et al. Coronavirus disease 2019 and transplantation: a view from the inside. Am J Transplant 2020; doi: 10.1111/ajt.15853.