Techniques in Coloproctology

21 Apr, 2020
The Italian Society of Colorectal Surgery (SICCR) published last week an article with some recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic. 

As a summary, they believe that the COVID-19 epidemic should not lead to approaches that impair oncologic results or expose patients to excessive morbidity. In COVID-19-negative patients, elective surgery should be performed following the current guidelines, using the least aggressive treatment possible and providing treatments in COVID-19-free hospitals (hopefully) or in hospitals where COVID-19-positive and -negative patients follow clearly separate pathways. In COVID-19-positive patients, recovery from the infection is the priority and cancer surgery should be reserved only for life-threatening situations. In both COVID-19-positive and COVID-19-negative cancer patients with an emergent presentation, the treatment should be as conservative as possible, avoiding surgery if feasible, using stent placement for stenosing cancer as bridge to surgery or as palliative treatment. Hartmann’s procedure should be considered instead of a low colorectal or coloanal anastomosis, or in presence of left-sided occlusion or perforation. Ostomies should be strongly considered.