Skip to main content
Top
Published in: European Journal of Medical Research 1/2021

Open Access 01-12-2021 | SARS-CoV-2 | Research

Safety of elective abdominal and vascular surgery during the COVID-19 pandemic: a retrospective single-center study

Authors: Sven Flemming, Mohammed K. Hankir, Simon Kusan, Manuel Krone, Friedrich Anger, Christoph-Thomas Germer, Armin Wiegering

Published in: European Journal of Medical Research | Issue 1/2021

Login to get access

Abstract

Background

Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission.

Methods

The screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded.

Results

Out of the study population (n = 657), 509 patients (77.5%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected.

Conclusion

The implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.
Literature
1.
go back to reference Flemming S, et al. Surgery in times of COVID-19-recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359–64.CrossRef Flemming S, et al. Surgery in times of COVID-19-recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359–64.CrossRef
5.
go back to reference Heinzerling A, et al. Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient—Solano County, California, February 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):472–6.CrossRef Heinzerling A, et al. Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient—Solano County, California, February 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):472–6.CrossRef
7.
go back to reference Lai X, et al. Coronavirus disease 2019 (COVID-2019) infection among health care workers and implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Netw Open. 2020;3(5): e209666.CrossRef Lai X, et al. Coronavirus disease 2019 (COVID-2019) infection among health care workers and implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Netw Open. 2020;3(5): e209666.CrossRef
8.
go back to reference Collaborative CO. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396(10243):27–38.CrossRef Collaborative CO. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396(10243):27–38.CrossRef
9.
go back to reference Lei S, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21: 100331.CrossRef Lei S, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21: 100331.CrossRef
11.
go back to reference Rosenbaum L. The untold toll—the pandemic’s effects on patients without Covid-19. N Engl J Med. 2020;382(24):2368–71.CrossRef Rosenbaum L. The untold toll—the pandemic’s effects on patients without Covid-19. N Engl J Med. 2020;382(24):2368–71.CrossRef
13.
go back to reference Chen N, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13.CrossRef Chen N, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13.CrossRef
14.
go back to reference Kruger S, et al. Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital. J Med Virol. 2021;93(5):2890–8.CrossRef Kruger S, et al. Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital. J Med Virol. 2021;93(5):2890–8.CrossRef
18.
go back to reference Kane AD, et al. Peri-operative COVID-19 infection in urgent elective surgery during a pandemic surge period: a retrospective observational cohort study. Anaesthesia. 2020;75(12):1596–604.CrossRef Kane AD, et al. Peri-operative COVID-19 infection in urgent elective surgery during a pandemic surge period: a retrospective observational cohort study. Anaesthesia. 2020;75(12):1596–604.CrossRef
19.
go back to reference Tilmans G, et al. Surgical outcomes after systematic preoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening. Surgery. 2020;168(2):209–11.CrossRef Tilmans G, et al. Surgical outcomes after systematic preoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening. Surgery. 2020;168(2):209–11.CrossRef
20.
go back to reference Huybens EM, et al. What is the preferred screening tool for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure? World J Surg. 2020;44(10):3199–206.CrossRef Huybens EM, et al. What is the preferred screening tool for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure? World J Surg. 2020;44(10):3199–206.CrossRef
21.
go back to reference Bellato V, et al. Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices. J Glob Health. 2020;10(2): 020507.CrossRef Bellato V, et al. Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices. J Glob Health. 2020;10(2): 020507.CrossRef
22.
go back to reference Puylaert CAJ, et al. Yield of screening for COVID-19 in asymptomatic patients before elective or emergency surgery using chest CT and RT-PCR (SCOUT): multicenter study. Ann Surg. 2020;272(6):919–24.CrossRef Puylaert CAJ, et al. Yield of screening for COVID-19 in asymptomatic patients before elective or emergency surgery using chest CT and RT-PCR (SCOUT): multicenter study. Ann Surg. 2020;272(6):919–24.CrossRef
23.
go back to reference Nekkanti SS, et al. Mandatory preoperative COVID-19 testing for cancer patients-Is it justified? J Surg Oncol. 2020;122(7):1288–92.CrossRef Nekkanti SS, et al. Mandatory preoperative COVID-19 testing for cancer patients-Is it justified? J Surg Oncol. 2020;122(7):1288–92.CrossRef
24.
go back to reference Ji C, et al. Is elective cancer surgery safe during the COVID-19 pandemic? World J Surg. 2020;44(10):3207–11.CrossRef Ji C, et al. Is elective cancer surgery safe during the COVID-19 pandemic? World J Surg. 2020;44(10):3207–11.CrossRef
25.
go back to reference Glasbey JC, et al. Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: an international, multicenter comparative cohort study. J Clin Oncol. 2021;39(1):66–78.CrossRef Glasbey JC, et al. Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: an international, multicenter comparative cohort study. J Clin Oncol. 2021;39(1):66–78.CrossRef
Metadata
Title
Safety of elective abdominal and vascular surgery during the COVID-19 pandemic: a retrospective single-center study
Authors
Sven Flemming
Mohammed K. Hankir
Simon Kusan
Manuel Krone
Friedrich Anger
Christoph-Thomas Germer
Armin Wiegering
Publication date
01-12-2021
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2021
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-021-00583-x

Other articles of this Issue 1/2021

European Journal of Medical Research 1/2021 Go to the issue