HE INFLUENCE OF THE COVID-19 PANDEMIC ON THE DIVERTICULAR DISEASE COMPLICATIONS TREATMENT

ABSTRACT

Introduction. The COVID-19 pandemic affected not only the organization of the entire healthcare system, but also made adjustments to the diagnosis and treatment of a wide range of diseases, including diverticular disease. Aim. Analysis of the results of inpatient care for patients with acute diverticulitis during the COVID-2019 pandemic. Material and methods: From 2017 to January 2022, 244 patients with diverticular disease were treated in coloproctology clinic. During the pandemic period (March 2020 – December 2021) there were 15 patients with COVID-2019 associated pneumonia who developed complications of diverticular disease. Results and discussion. An increase of hospitalizations of patients with complicated forms of the disease was established, while patients with uncomplicated diverticular disease were hospitalized less frequently. There was also a decrease in the number of reconstructive surgeries in 2020. The most informative diagnostic tool that allows to verify complicated forms of diverticular disease and determines further treatment tactics, especially in the COVID-19 pandemic, is X-ray computed tomography with intravenous contrast, which was performed in 53.3% of patients. The number of urgent surgical interventions increased, including in patients with COVID-2019. During the pandemic, minimally invasive interventions began to be performed more often, allowing the patient to be treated as gently as possible. Moreover, drainage of abscess under ultrasound guidance is currently becoming a popular procedure even with large abscesses (>3 cm). This technology should be considered as bridge operation before a radical intervention, which implementation should be carried out after the stabilization of the general condition of the patient. Diffuse peritonitis in COVID-positive patients continues to be considered as an indication for emergency laparotomy. At the same time, Hartmann-type operations should be performed, refusing the extended intestinal resection and primary anastomosis. Conclusion. The COVID-19 pandemic has made adjustments to the organization of medical care for patients with diverticular disease. In this regard, it is advisable to conduct interdisciplinary multicenter research in order to study the influence of the pandemic on the course of the disease and take early measures to minimize the negative consequences of the pandemic. © 2022, LLC "IMC" Modern Clinical Medicine. All rights reserved.