06 april 2020

Webinar AIS 27-3-2020 (Colorectal surgery)

Lessons from Beijing Friendship hospital and Wuhan hospital

Over 400,000 cases worldwide
Outpatient clinic:
- entrance control: measure temperature
- all health care workers wear surgical masks and protection glasses
- extra investigation if: fever / respiratory symptoms or if patient visited endemic area or contacted a confirmed case < 14 days
Preoperative screening: CRP + ct-thorax
- pulmonists and infectiologists should be added to colorectal MDT
elective surgery
- postpone if possible, open is safer for surgical staff than laparoscopic
- stage i/ii → postpone 30-60 dys
- stage iii → ct4 coloncancer: nCT capox, ct3/n+ rectal cancer: long course ncrt / nct
- stage iv → capox followed by metachronous surgery
emergency surgery (hemorrhage, obstruction, perforation)
- also screen by ct thorax and crp
  - positive screen:
    - negative pressure on OR, open surgery, perform surgery in designated hospital, proper protection for surgical staff
Postoperative management:
- no covid:
  - normal surgical ward with extra desinfection measures
  - normal eras
  - fever → direct isolation and ct-thorax
- covid:
  - isolation ward in close cooperation with pulmonologist
  - administer O2 and monitor saturation closely
- Remove patients from isolation if:
  - Temperature normal for 3 days
  - marked improvement in respiratory symptoms
  - marked radiological improvement
  - 2x negative pCR