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1.
Chirurg ; 92(10): 929-935, 2021 Oct.
Article in German | MEDLINE | ID: covidwho-1375626

ABSTRACT

BACKGROUND: The outbreak of the coronavirus disease 2019 (COVID-19) pandemic imposed limitations for elective surgery, impacting the associated hospital standards worldwide. As certain treatment windows must be adhered to in oncological surgery, the limited intensive care unit (ICU) capacity had to be critically distributed in order to do justice to both acutely ill and oncology patients. This manuscript summarizes the impact of COVID-19 on the management of oncological surgery of the upper gastrointestinal tract and particularly esophageal surgery in German medical centers. MATERIAL AND METHODS: A survey of German centers for esophageal surgery was performed on the impact of COVID-19 on operative management for esophageal surgery during the first lockdown. After inspection, assessment, critical analysis and interpretation, the results were compared to the international literature. RESULTS AND DISCUSSION: Initial recommendations of international societies warned for caution and restraint regarding interventions of the upper gastrointestinal tract that were not absolutely necessary. Oncological surgery should be performed under strict restrictions, especially only after negative testing for COVID-19 and only with sufficiently available personal protective equipment for the personnel. Furthermore, minimally invasive procedures were preferably not recommended. In diseases with alternative treatment options, such as definitive chemoradiotherapy of esophageal squamous cell carcinoma, these should be given priority when possible. In the further development of the pandemic, it was shown that due to a high standardization of preoperative management, postoperative results comparable to pre-pandemic times could be achieved particularly with respect to the diagnostics of infections.


Subject(s)
COVID-19 , Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Upper Gastrointestinal Tract , COVID-19 Testing , Communicable Disease Control , Esophageal Neoplasms/surgery , Humans , SARS-CoV-2
2.
Rev Esp Enferm Dig ; 113(2): 148, 2021 02.
Article in English | MEDLINE | ID: covidwho-1000689

ABSTRACT

The COVID-19 has great impact on the health behavior of all people around the world, however its influence on patients with upper gastrointestinal foreign bodies remains unknown. In the present study, we found for the first time that during COVID-19 pandemic, patients with upper gastrointestinal foreign bodies were more likely to consult later and with a higher rate of hospitalization.


Subject(s)
COVID-19 , Foreign Bodies , Hospitalization/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Upper Gastrointestinal Tract , Adult , Aged , Female , Humans , Male , Middle Aged , Time Factors
3.
J Gastrointest Cancer ; 52(2): 407-413, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-947062

ABSTRACT

INTRODUCTION: The safety of upper gastrointestinal cancer patients in the SARS-CoV-2 outbreak is extremely important and most surgeons need to establish a contingency management. AIM: In this study, we present the surgical outlines of patients suffering from upper gastrointestinal cancers. MATERIALS AND METHODS: Data were obtained from PubMed, Cochrane Database of Controlled Trials, and SCOPUS of reports up to September 2020. RESULTS: The COVID-19 outbreak makes surgical procedures extremely difficult to be performed. The most common criteria to prioritize patients for surgical treatment are stage, tumor biology, presence of tumor-related symptoms, the risk of tumor to become non-resectable, and time interval from neoadjuvant therapy. The multidisciplinary teams can help assigning a priority level to each clinical case. CONCLUSION: We have to continue providing treatment to oncologic patients in the face of COVID-19 uncertainty, with higher caution and responsibility in order to develop a safer and more effective personalized treatment plan.


Subject(s)
COVID-19/epidemiology , Endoscopy, Gastrointestinal , Gastrointestinal Neoplasms/surgery , SARS-CoV-2 , Algorithms , COVID-19/etiology , Gastrointestinal Neoplasms/complications , Gastrointestinal Neoplasms/diagnosis , Humans , Risk Factors , Upper Gastrointestinal Tract
4.
Clin Res Hepatol Gastroenterol ; 45(3): 101521, 2021 May.
Article in English | MEDLINE | ID: covidwho-712926

ABSTRACT

BACKGROUND: COVID-19 patients have an increased susceptibility to develop thrombotic complications, thus thromboprophylaxis is warranted which may increase risk of upper gastrointestinal bleeding (UGIB). Our aim was to evaluate incidence of UGIB and use of upper GI endoscopy in COVID-19 inpatients. METHODS: The medical and endoscopic management of UGIB in non-ICU COVID-19 patients has been retrospectively evaluated. Glasgow Blatchford score was calculated at onset of signs of GI bleeding. Timing between onset of signs of GI bleeding and execution, if performed, of upper GI endoscopy was evaluated. Endoscopic characteristics and outcome of patients were evaluated overall or according to the execution or not of an upper GI endoscopy before and after 24h. RESULTS: Out of 4871 COVID-19 positive patients, 23 presented signs of UGIB and were included in the study (incidence 0.47%). The majority (78%) were on anticoagulant therapy or thromboprophylaxis. In 11 patients (48%) upper GI endoscopy was performed within 24h, whereas it was not performed in 5. Peptic ulcer was the most common finding (8/18). Mortality rate was 21.7% for worsening of COVID-19 infection. Mortality and rebleeding were not different between patients having upper GI endoscopy before or after 24h/not performed. Glasgow Blatchford score was similar between the two groups (13;12-16 vs 12;9-15). CONCLUSION: Upper GI bleeding complicated hospital stay in almost 0.5% of COVID-19 patients and peptic ulcer disease is the most common finding. Conservative management could be an option in patients that are at high risk of respiratory complications.


Subject(s)
Anticoagulants/adverse effects , COVID-19/complications , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage/chemically induced , Gastrointestinal Hemorrhage/epidemiology , Upper Gastrointestinal Tract , Venous Thromboembolism/prevention & control , Aged , Aged, 80 and over , Anticoagulants/therapeutic use , Female , Gastrointestinal Hemorrhage/diagnosis , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Retrospective Studies , Venous Thromboembolism/etiology
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