Ulus Travma Acil Cerrahi Derg. 2022; 28(3): 395-398 | DOI: 10.14744/tjtes.2020.57746

Obstrüksiyon nedeni ile COVID-19 tedavisi alamayan özofagus kanserli hastada acil cerrahi gastrostomi açýlmasý ve rehberler gözetilerek alýnan ameliyathane önlemleri: Olgu sunumu

Ömer Yalkýn¹, Nidal Iflazoðlu¹, Serra Topal², Mustafa Yener Uzunoðlu^3
1Bursa Þehir Hastanesi, Cerrahi Onkoloji Kliniði, Bursa
²Bursa Þehir Hastanesi, Anestezi ve Reanimasyon Kliniði, Bursa
³Kestel Devlet Hastanesi, Genel Cerrahi Kliniði, Bursa

Özofagus kanseri nedeni ile oral alýmý olmayan COVID-19 tanýlý olguda, COVID-19 tedavisi baþlanabilmesi için yapýlan gastrostomi prosedürü ve pandemi rehberleri eþliðinde uygulanan COVID-19 protokollerini sunmayý amaçladýk. Elli beþ yaþýnda özofagus skuamoz hücreli karsinom yeni tanýlý kadýn hasta neoadjuvan kemoradyoterapi öncesi özofagusta tam obstrüksiyon nedeniyle oral alamadýðý için cerrahi gastrostomi açýlmasý için konsülte edildi. Kliniðimize baþvuru anýnda yeni baþlayan öksürük þikayetinin olmasý ve ölçülen vücut sýcaklýðýnýn yüksek olmasý (38°C) nedeni ile COVID-19 açýsýndan tetkik edildi ve PCR ile kesin tanýsý konuldu. Oral COVID-19 tedavisine baþlanabilmesi için yarý acil þartlarda COVID-19 bulaþ önleme rehberlerine uyularak cerrahi gastrostomi açýldý. Gastrostomi kateterinden COVÝD-19 tedavisi, nutrisyon ve destek tedavisi baþlandý. Hastamýz tedavisinin yedinci gününde klinik olarak stabil seyretmektedir. Pandemi mücadelesi içerisinde COVID-19 hastasýnda acil cerrahi giriþim ihtiyacý olabilir. Cerrahi iþlem uygulanacaðý zaman tüm saðlýk personelini COVID-19 bulaþýndan koruyacak tanýmlanmýþ rehberlere uyulmalýdýr.

Anahtar Kelimeler: COVID-19, gastrostomi, kiþisel koruyucu ekipman, özofagus kanseri; pandemi.

---

Emergency surgical gastrostomy in an esophageal cancer patient unable to receive COVID-19 treatment due to obstruction, and operating room measures as per pandemic guidelines: Case report

Ömer Yalkýn¹, Nidal Iflazoðlu¹, Serra Topal², Mustafa Yener Uzunoðlu^3
1Department of Surgical Oncology, Bursa City Hospital, Bursa-Turkey
²Department of Anesthesiology and Reanimation, Bursa City Hospital, Bursa, Turkey
³Department of General Surgery, Kestel State Hospital, Bursa, Turkey

We present here a gastrostomy procedure performed on a patient diagnosed with COVID-19 with no oral intake due to esophageal cancer in order to permit the initiation of COVID-19 treatment, and the COVID-19 protocols followed as per the pandemic guidelines. A 55-year-old female patient diagnosed recently with esophageal squamous-cell carcinoma was consulted for a surgical gastrostomy in the absence of oral intake due to complete esophageal obstruction prior to neoadjuvant chemotherapy. The patient had a new-onset cough and elevated body temperature (38°C) on admission to our clinic, and so was tested for COVID-19, with the final diagnosis established with PCR. In order to initiate COVID-19 treatment, a surgical gastrostomy was performed under semi-emergency conditions, following COVID-19 infection prevention guidelines. COVID-19 treatment, nutrition, and supportive therapy were initiated through the gastrostomy catheter. The patient is clinically stable on day 7 of treatment. A COVID-19 patient may require emergency surgical intervention during the fight against pandemic. When a surgical procedure is performed, all guidelines defined to protect healthcare workers from COVID-19 infection should be followed.

Keywords: COVID-19, esophageal cancer; gastrostomy; pandemics; personal protective equipment.

---

ATIF KOPYALA