COVID-19 PANDEMİ PERİYODUNDA BİR AYLIK CERRAHİ ONKOLOJİ KLİNİK DENEYİMİMİZ
Giriş: Çin'de 2019'un sonlarında ortaya çıkan ve daha sonra tüm dünyayı etkileyen COVID-19 enfeksiyonu ilk olarak Mart 2020'de ülkemizde görülmüş ve gerekli önlemlerle bu salgına karşı mücadele başlamıştır. COVID-19 enfeksiyonunun bağışıklığı baskılanmış kişilerde daha yaygın olduğu ve bu gruptaki tedaviye rağmen daha ölümcül bir seyir gösterdiği gözlenmiştir. Kanser tedavisinde önemli bir rol oynayan onkolojik ameliyatlar yapan klinikler, bu dönemde yayınlanan pandemik kılavuz ilkelere uygun olarak kişisel koruyucu ekipman, fiziksel çevre önlemleri ve klinik operasyonel ayarlamaları kullanarak operasyonlara devam etmek zorunda kalmıştır. Bu çalışma, önümüzdeki süreçte COVID-19 ile mücadele sürerken, onkolojik cerrahi girişimlerde oluşturulacak kılavuzlara katkı amacıyla tasarlandı. Gereç ve Yöntem: Bu çalışmada 21 Mart 2015 ile 21 Nisan 2020 tarihleri arasında Bursa Şehir Hastanesi Cerrahi Onkoloji Kliniği 'ne tedavi amacıyla başvuran 44 olgunun verileri analiz edildi. Bulgular: Tedavi edilen 44 olgunun 26'sı (% 59.1) erkek, 18'i (% 40.9) kadındı. Yaş ortalaması 64,25 (22-83) idi. 16 (% 36.4) olguda komorbidite yok iken 28 hastada komorbidite vardı. Tedavi 30 (% 68.2) olguda cerrahi, 11 (% 25) olguda invaziv lokal işlemler ve 3 (% 6.8) olguda tıbbi destek idi. Tedavi edilen hastaların tanısı; kolorektal malignite (14,% 31.8), mide kanseri (7,% 15.9), meme kanseri (4, %9), pankreas kanseri (4, % 9), özofagus kanseri (2,% 4.5) ve diğer kanserler (lenfoma, karaciğer malignitesi, nazofaringeal karsinom, tiroid kanseri, vb., 13, %28.3) idi. Ameliyat öncesi klinik ve laboratuvar COVID-19 pnömoni bulguları olmayan hastalarda, ameliyattan sonra COVID-19 pnömoni bulaşı saptanmadı. Sonuç: Pandemi döneminde kaçınılmaz olarak yapılması gereken kanser ameliyatlarında ameliyat sonrası COVID-19 bulaşını azaltmak uygun hastane şartları ve klavuzlara uymak ile mümkündür. Cerrahi onkoloji kliniklerinin geriye dönük olarak alınacak dersler, COVID-19 gibi gelecekteki salgınlarda hasta yönetimi, halk sağlığının korunması ve cerrahi kliniklerde alınması gereken önlemler açısından COVID-19'dan nasıl etkilendiğini bilmek olmalıdır.
OUR ONE-MONTH SURGICAL ONCOLOGY CLINICAL EXPERIENCE IN COVID-19 PANDEMIC PERIOD
Introduction: COVID-19 infection, emerging in late 2019 in China and subsequently affecting the whole world, was first seen in March 2020 in our country and a fight against this outbreak was begun with taking necessary precautions. It has been observed that COVID-19 infection is more common in immunocompromised individuals and shows a more fatal course despite treatment in this group. Clinics performing oncologic surgeries, which play a key role in cancer treatment, had to continue operations using personal protective equipment, physical environment precautions and clinical operational adjustments in accordance with pandemic guidelines published within this period. This study was designed to contribute to the guidelines to be created in oncological surgical interventions while the fight against COVID-19 continues in the upcoming period. Material and Method: The present paper analyzed the data of 44 cases admitted for treatment purposes to the Surgical Oncology Clinic of Bursa City Hospital between March 21 - April 21, 2020. Results: Among 44 cases treated, 26 (59.1%) were male and 18 (40.9%) were female. The mean age was 64.25 (22-83) years. No comorbidity was present in 16 (36.4%) cases, while 28 patients had comorbidities. Treatment was surgical in 30 (68.2%) cases, invasive local procedure in 11 (25%) and medical support in 3 (6.8%) cases. The diagnoses of treated patients, in descending order of frequency, were colorectal malignancy (14, 31.8%), gastric cancer (7, 15.9%), breast cancer (4, 9%), pancreatic cancer (4, 9%), esophageal cancer (2, 4.5%) and other (lymphoma, liver malignancy, nasopharyngeal carcinoma, thyroid cancer, etc., 13, 28.3%). In patients without clinical and laboratory COVID-19 pneumonia findings before surgery, COVID-19 transmission was not detected after surgery. Conclusion: COVID-19 pneumonia infection was not observed after surgery in the one-month period, after the good isolation of the patients and the applications performed by considering the guidelines. It is important to know how surgical oncology clinics are affected by COVID-19 in terms of lessons to be taken retrospectively, patient management in future outbreaks like COVID-19, protection of public health, and precautions to be taken in surgery clinics.
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