COVID-19: impact on colorectal surgery.

Area of Science:

• Colorectal surgery
• Infectious disease control
• Operating room management

Background:

• The COVID-19 pandemic presented significant challenges to surgical healthcare systems globally.
• Urgent and emergency colorectal surgeries, including for cancer, necessitated rapid adaptation of operating room (OR) protocols.

Purpose of the Study:

• To address critical considerations for patient and caregiver safety during colorectal surgery amidst the COVID-19 pandemic.
• To evaluate operating room (OR) utilization and techniques in the context of pandemic-related safety measures.

Main Methods:

• Discussion of knowledge regarding personal protective equipment (PPE) and OR environment safety.
• Analysis of the impact of negative-pressure environments and aerosol-generating procedures (AGPs) on surgical practices.
• Review of lessons learned from pressurized intraperitoneal aerosolized chemotherapy procedures.

Main Results:

• Additional PPE may be required based on local COVID-19 testing availability and infection rates.
• Negative-pressure environments are recommended for ORs, especially during aerosol-generating procedures (AGPs).
• Minimally invasive surgery with pneumoperitoneum is an AGP requiring careful consideration and safety measures.

Conclusions:

• Safe approaches to colorectal surgery during the COVID-19 pandemic involve managing the OR environment and AGPs.
• While no single answer is universally agreed upon, logical and safe strategies have been presented.
• Emphasis on patient and caregiver safety through appropriate PPE and environmental controls is paramount.