• Zhonghua Wei Chang Wai Ke Za Zhi · Mar 2020

    [Standardized diagnosis and treatment of colorectal cancer during the outbreak of corona virus disease 2019 in Renji hospital].

    • Y Luo and M Zhong.
    • Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.
    • Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Mar 25; 23 (3): 211-216.

    AbstractCorona virus disease 2019 (COVID-19) is currently raging in China. It has been proven that COVID-19 can be transmitted from human to human and cause hospital infection, which seriously threatens surgical staffs and inpatients. Although colorectal surgery is not a front-line subject in the fight against the epidemic, but in this special situation, it is a difficult task to provide the highest quality medical services and ensure the orderly clinical work, on the premise of maximizing the protection for patients and their families, health of medical staff, and the safety of wards and hospitals, We summarize how to carry out the clinical practice of colorectal surgery under the situation of the prevention and control of the COVID-19 epidemiology, including the procedures of diagnose and treatment for emergency patients with colorectal tumor, and share the experiences of the diagnosis of colorectal tumor, the management of patients with colorectal cancer who are scheduled to be admitted for surgery, the protection of wards, the perioperative management. More importantly, we introduce in detail the operative management and perioperative management of colorectal surgery patients suspected or diagnosed with new coronary pneumonia, including prevention and control measures for medical staff, operating rooms and surgical instruments. The main points are as follows: (1) Multidisciplinary team (MDT) must be run through the diagnosis and treatment of colorectal cancer. The members include not only routine departments, but also respiratory department and infectious department. (2) Colonoscopy examination may cause cross infection of COVID-19 to patients and doctors. Therefore, it is prior to examine the emergency cases and life-threatening patients (bleeding, obstruction, gastrointestinal foreign bodies, etc.). If the emergent patients (intestinal obstruction) with suspected or confirmed COVID-19, the surgeons must perform emergency surgery, and intestinal decompressive tube through colonoscopy is not recommended. (3) The colorectal cancer patients with suspected or confirmed COVID-19 should be placed in the isolated room with separate medical devices, and the operative room with negative pressure (under -5 Pa) must be separated. All disposable medical items, body fluids and feces of the patients in perioperative periods must be unified disposed according to the medical waste standard. (4) The surgical medical workers who process colorectal cancer patients with COVID-19 must be protected by three-level. After operation, the medical workers must receive medical observation and be isolated for 14 days. We hope our "Renji experience" will be beneficial to colleagues.

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