How should be the Surgical Treatment Approach during the COVID-19 Pandemic in Patients with Gastrointestinal Cancer?

COVID-19 was first seen in China at the end of December 2019. COVID-19 is a novel type of coronavirus that is defined as SARS-CoV-2, which can be mild or severe in the lungs, causing acute respiratory infection. The disease was first presented in the literature as Coronavirus Disease 2019 (COVID-19) in February 2020. The disease spread rapidly and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. There have been approximately 7734185 reported cases, and 412369 reported deaths to date (09/June/2020).
As COVID-19 spread in the world and our country, hospitals struggling with this disease have also become risky areas for transmitting the disease. Health workers also have a high risk of viral contamination from direct contact of droplets and surfaces. Personal protective equipment (PPE), such as masks, coveralls, gloves, face shields and/or goggles, are mandatory. The aim is to spread the flow of cases requiring hospitalization over time, thereby preventing possible accumulation in hospitals.
All non-urgent procedures, such as elective surgeries and diagnostic interventions, were significantly affected. The hospitalization procedures were mostly allocated to patients with COVID-19 infection, and surgical operations were postponed. Only urgent surgical cases and oncological surgeries that cannot be postponed were performed during this pandemic process.
Patients followed by oncology are immunosuppressed both because of the disease itself and the side effects of chemotherapy and/or radiotherapy taken. This makes patients more susceptible to infections, and the prognosis of infections in these patients is worse and more destructive. Cancer patients are almost twice as likely to catch COVID-19 compared to the general population.
The choice of surgical procedures and perioperative management of the patients with malignancy has become even more important in the COVID-19 pandemic. In this study, we analyzed the treatment processes of our patients with malignancy that underwent a surgical oncological procedure during this pandemic.

Gastrointestinal kanserli hastalarda COVID-19 pandemisi sürecinde cerrahi tedavi yaklaþýmý nasýl olmalýdýr?

COVID-19 ilk olarak Aralýk 2019'un sonunda Çin’de görülmüþtür. COVID-19, akciðerlerde hafif veya þiddetli olabilen ve akut solunum yolu enfeksiyonuna yol açan SARS-CoV-2 olarak tanýmlanmýþ yeni bir koronavirüs türüdür. Hastalýk literatürde ilk kez Þubat 2020 ' de Coronavirus Hastalýðý 2019 (COVID-19) olarak bildirilmiþtir. Hastalýk hýzla yayýlmýþ ve 11 Mart 2020'de Dünya Saðlýk Örgütü (WHO) tarafýndan bir salgýn olarak ilan edilmiþtir. Bugüne kadar yaklaþýk 7734185 vaka ve 412369 kadar da ölüm bildirmiþtir (09 / Haziran / 2020).
COVID-19 dünyaya ve ülkemize yayýldýkça, bu hastalýkla mücadele eden hastaneler de hastalýðýn bulaþmasý için riskli alanlar haline gelmiþtir. Saðlýk çalýþanlarýnýn damlacýklar ve yüzeylerden doðrudan temas yolu ile viral kontaminasyon riski yüksektir. Maskeler, tulumlar, eldivenler, yüz siperleri ve / veya gözlükler gibi kiþisel koruyucu ekipmanlar (KKEE) zorunludur. Amaç, hastaneye yatmayý gerektiren vakalarýn akýþýný zamanla yaymak, böylece hastanelerde olasý birikimi önlemektir.
Elektif ameliyatlar ve tanýsal müdahaleler gibi acil olmayan tüm prosedürler önemli ölçüde etkilenmiþtir. Hastaneye yatýþ prosedürleri çoðunlukla COVID-19 enfeksiyonu olan hastalara tahsis edildiðinden ve cerrahi operasyonlar ertelendi. Bu pandemi sürecinde ise sadece acil cerrahi olgular ve ertelenemeyen onkolojik ameliyatlar yapýldý.
Onkoloji hastalarýnýn, hem hastalýðýn kendisi, hem de alýnan kemoterapi ve / veya radyoterapinin yan etkileri nedeniyle baðýþýklýðý baskýlanmýþtýr. Bu durum, hastalarý enfeksiyonlara karþý daha hassas hale getirir ve bu hastalardaki enfeksiyonlarýn prognozu daha kötü ve yýkýcýdýr. Kanser hastalarýnýn genel popülasyona kýyasla COVID-19'a yakalanma olasýlýklarý neredeyse iki kat daha fazladýr.
COVID-19 pandemisinde malignitesi olan hastalarýn cerrahi prosedürlerinin seçimi ve perioperatif yönetimi daha da önemli hale gelmiþtir. Çalýþmamýzda, bu pandemi sýrasýnda malignitesi olan ve cerrahi onkolojik giriþim yapýlan hastalarýmýzýn tedavi süreçlerini analiz ettik. (SETB-2020-06-089)