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Asian J Endosc Surg ; 14(3): 620-623, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1294946


The pandemic of COVID-19 has been a game changer in many aspects of medical care, including laparoscopic surgery service. Uncertainty in the early pandemic has led to the fear of doing laparoscopic surgery with regard to the possibility of SARS-COV-2 transmission through surgical smoke. We carried out laparoscopic surgery during the COVID-19 pandemic with intention to test our local adaptation of a laparoscopic smoke evacuator. Twenty-five laparoscopic cases for digestive surgery were performed with uneventful results. In summary, a low cost local adaptation of laparoscopic smoke and safe surgical behavior should be the standard of care when delivering laparoscopic surgery service in the pandemic era and forward.

COVID-19 , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Laparoscopy/methods , Laparotomy/methods , Smoke/adverse effects , Ventilation/methods , Humans , Infection Control/methods , Pandemics , SARS-CoV-2
BMJ Case Rep ; 14(3)2021 Mar 02.
Article in English | MEDLINE | ID: covidwho-1115111


We describe a case of retrovesical liposarcoma in a male patient with concurrent COVID-19. A 50-year-old man had lower urinary tract symptoms and dull pain along his right gluteus. Due to COVID-19 infection, management was delayed. During self-isolation, the patient developed urinary retention and his pain level was an eight on the Visual Analogue Scale. A urinary catheter and an epidural catheter were inserted without any difficulty. Abdominal-pelvic MRI revealed a retrovesical mass suspected of liposarcoma with clear borders from surrounding organs. Following two consecutive negative SARS-CoV-2 PCR tests, we proceeded with surgery. Histopathology was dedifferentiated liposarcoma. Postoperatively, the patient suffered reactivation of COVID-19, and he was eventually discharged after two consecutive negative results on the PCR test on Post Operative Day (POD)-10. Retrovesical dedifferentiated liposarcoma is rare and considered as high-grade liposarcoma. Although surgery may exacerbate COVID-19 infection, surgical resection of symptomatic high-grade sarcoma is prioritised and performed as soon as no infection detected.

COVID-19/diagnosis , Liposarcoma , Lower Urinary Tract Symptoms , Pelvic Neoplasms , SARS-CoV-2/isolation & purification , Surgical Procedures, Operative/methods , Urinary Retention , COVID-19/therapy , Chemoradiotherapy, Adjuvant/methods , Dissection/methods , Humans , Liposarcoma/pathology , Liposarcoma/physiopathology , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/etiology , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neoplasm Grading , Pelvic Neoplasms/pathology , Pelvic Neoplasms/physiopathology , Time-to-Treatment , Treatment Outcome , Urinary Retention/diagnosis , Urinary Retention/etiology
Asian J Endosc Surg ; 14(3): 540-547, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1007355


INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, digestive surgery potentially exposes both health-care professionals and vulnerable patients to COVID-19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID-19 pandemic, optimize safety for patients and clinicians, and safeguard health-care services. METHODS: An online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID-19 pandemic. RESULTS: Early in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3-100 cases) to 1 case (range. 0-10 cases) (P < .001; Wilcoxon signed-rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of screening for COVID-19 with polymerase chain reaction has increased over time, and a more comprehensive screening methodology incorporating real-time polymerase chain reaction, chest CT, and rapid antibody test were evident in 31.37% of July 2020 responses. CONCLUSION: Our survey has shown that surgeons adapted to the evolving pandemic and continue to do so only with appropriate safety assurances.

COVID-19 , Delivery of Health Care/organization & administration , Digestive System Surgical Procedures/statistics & numerical data , Surgeons/psychology , Digestive System Surgical Procedures/trends , Humans , Indonesia , Pandemics , Practice Patterns, Physicians' , SARS-CoV-2 , Surveys and Questionnaires