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RSACP wishes to inform that it shall be discontinuing the dispatch of print copy of JOACP to it's Life members. The print copy of JOACP will be posted only to those life members who send us a written confirmation for continuation of print copy.
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 36  |  Issue : 3  |  Page : 325-330

A rational approach to manage surgical procedures in COVID Era – A perspective based on experience in a private referral hospital


1 Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
2 Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
3 Department of Anesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
4 Department of Obstetrics and Gynecology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
5 Department of Gastrointestinal Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
6 Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Correspondence Address:
Dr. Kamakshi Garg
Department of Anesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacp.JOACP_420_20

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Background and Aims: COVID-19 disease has imposed challenges in caring for non-Covid elective surgical patients. As elective surgeries become essential, we propose to evaluate our approach and outcomes of surgical procedures performed during the initial period of COVID-19 pandemic so as to provide a road-map for safer approach. Material and Methods: We retrospectively evaluated outcomes in patients who underwent essential elective and emergency surgeries during the 5-week period between April 18, 2020 and May 28, 2020. All patients were screened at the front desk on their arrival to identify possible exposure to SARS- CoV-2. Nasopharyngeal swab of patients requiring hospital admission was tested for COVID-19 by quantitative RT-PCR. Patients needing essential elective surgery were taken up for surgery if they tested negative for COVID-19. Emergency procedures were undertaken in a demarcated theatre for COVID after taking level-3 protection without delay. The clinical data was reviewed and analysed. Results: A total of 764 surgical procedures were conducted, of which 70.7% were elective essential surgeries, with 95.4% of these patients being discharged in stable healthy condition. Approximately 23% of the elective and 26% of the emergency surgeries was categorised in the surgical difficulty category III and majority of these were performed under general anesthesia. Postoperative mortality was 1.04%, but the overall mortality rate was approximately 2.5%. Only two patients (0.3%) tested positive for COVID-19 in our series. Conclusion: A robust preoperative screening and testing can enable safe scheduling of essential elective surgeries.


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