Fumiaki Yano*, Takahiro Masuda, Masami Yuda, Yuichiro Tanishima, Katsunori Nishikawa, Muneharu Fujisaki, Norio Mitsumori, Takashi Ohtsuka, Toru Ikegami and Takao Ohki
Department of Surgery, Jikei University School of Medicine, Tokyo, JapanFulltext PDF
Objectives: The Jikei University Hospital (JKUH) declared a hospital-wide state of emergency on 4th April 2020, the day after confirming its first COVID-19 nosocomial infections, generally suspending first-time outpatient consultations, new admissions, and non-urgent procedures and tests. This report details how upper gastrointestinal surgeries at JKUH were affected by the COVID-19 pandemic. Methods: The records of 103 patients scheduled for elective surgery to treat an upper gastrointestinal disease or condition at JKUH between January and April 2020 were reviewed to assess our institution?s response and areas for improvement. Results: Starting 20th April, all inbound patients were screened for COVID-19 through RT-PCR and chest CT, a policy that successfully prevented new nosocomial infections from asymptomatic carriers. 80.0% of the scheduled surgeries were performed as planned (n=82), none of whom were COVID-19-positive. However, 20.0% (n=21) of the procedures had to be postponed, 38.1% (n=8) of which were to treat malignant disease. Five of them were postponed despite their malignancy due to the need to ensure sufficient availability of ICU beds. In addition, our gastrointestinal surgery division decided to cancel all operations to treat benign conditions in the pandemic?s wake; however, the quality-of-life reductions experienced by patients with achalasia or GERD - comprising 85% of the cases - are hard to reconcile with a designation of ?non-urgent?. Conclusion: The COVID-19 pandemic forced our department to postpone 20% of the scheduled upper gastrointestinal surgeries. Surgery was still indicated for all cases, and those designated as ?non-urgent? would nonetheless have benefited from quicker intervention.
COVID-19; SARS-CoV-2; 2019-nCoV; Coronavirus; Nosocomial infection; Gastrointestinal surgery; UGI surgery
Yano F, Masuda T, Yuda M, Tanishima Y, Nishikawa K, Fujisaki M, et al. Impact and Counter Measures of COVID-19 Nosocomial Infection on Upper Gastrointestinal Surgery. Clin Surg. 2020; 5: 2965.