Khirurgiia
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A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery. ⋯ To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still actively developed considering the benefits of treatment and risks of SARS-CoV-2 infection. Resumption of elective surgery should be progressive and cautious, especially in pandemic areas. For safety reasons, all patients eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.
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To perform a meta-analysis of studies examining the effectiveness of the local application of vancomycin powder for the prophylaxis of surgical site infections (SSIs) in spine surgery. ⋯ Topical application of vancomycin powder is highly effective in preventing the development of SSIs in patients after spinal surgical interventions.
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To summarize an experience of endoscopy-assisted dilatational tracheostomies in patients with COVID-19. ⋯ Endoscopy-assisted dilatational tracheostomy is preferred for prolonged mechanical ventilation, including patients with COVID-19. The undeniable advantages of this operation are fewer intraoperative complications due to endoscopic control, and lower risk of tracheal strictures.
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The article presents an algorithm for perioperative nutritional support of surgical patients operated on as planned. Today, planned surgical care is provided in accordance with the canons of the accelerated rehabilitation Program (ARP). ⋯ The predominant method is the enteral delivery of nutrients and energy. Oral supplemental nutrition by sipping is a convenient way to correct nutritional disorders at all stages of the perioperative period.
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Available data indicate a worse prognosis in cancer patients with COVID-19. Surgical treatment of lung cancer in the conditions of the COVID-19 pandemic poses new challenges to ensure the perioperative safety of patients.