General Surgery during Pandemic Era – Evolving Strategies: A Cohort Study from a Tertiary Care Centre in North India

Abstract

Due to Corona Virus disease 2019 (CoViD-19) pandemic, healthcare systems worldwide have been suffering in terms of their capability to manage affected people and the ability to provide standard treatment. Multiple vaccines have been developed and it is being implemented globally on a large scale. However, mutant strains of the virus are being detected from all parts of the world and pandemic and it’s associated concerns are continuing. With the majority of patients being asymptomatic and high infectivity, safety related concerns have been there both for patients as well as healthcare workers. Various academic associations have issued guidelines to address these issues. The authors aim to provide a comprehensive overview of essential measures that healthcare providers and surgeons adopted to ensure safe performance of both elective and emergency surgical procedures at their institute. Total of 506 patients underwent 512 general surgical elective and emergency procedures between 1st April 2020 to 31st December 2020 for different indications. The surgeries included both laparoscopic and open approaches. The strategies for preoperative testing for the presence of SARS nCov2 have been varying with availability of more evidence and techniques. For the initial six months, it was primarily RT PCR for both elective and emergency cases. However, in the last three months, the majority of the patients were tested for SARS nCov2 via RT PCR and emergency cases who were tested by CBNAAT Gene-Xpert. The pandemic has affected the patient care globally. Various guidelines have been issued by different academic associations. However, every institution has to improvise depending upon the local resources and infrastructure available. With continuing pandemic every institution shall require infrastructural changes to continue to deal with continuous inflow of infected patients.