Clinics (Sao Paulo). 2020;75:e1982.

Thoracic surgery in a hospital dedicated to treating COVID-19: challenges and solutions

Alessandro Wasum Mariani , Paulo M. Pêgo-Fernandes

DOI: 10.6061/clinics/2020/e1982

Some settings were established:

After 30 days of activities, the Central Institute have attended to a cumulative number of 1,194 cases. The thoracic surgery team was called to attend to 62 cases. Out of these, 41 patients (66%) had a confirmed diagnosis of COVID-19, and 21 patients were suspected of COVID-19 and were awaiting testing. Nineteen patients (30%) did not need additional procedures. The most common procedures (n=43) included tracheostomy (n=18), and thoracic drainage (n=13). Other procedures were minor interventions, such as tracheostomy tube changes, thoracentesis, and removal of the ‘Montgomery T-tube.’ The only major surgery was a correction of tracheal injury, via endosuture plus tracheostomy. Among all the procedures, we observed only one complication, which was a surgical wound infection following a tracheostomy. However, it was resolved upon following local care measures.

With regards to team safety, PPE were available in 100% of the procedures. However, out of the 43 procedures, a few protocol breaches such as the disconnection of ventilation without an appropriate pause, occurred in six procedures (13%). So far, none of the members of the thoracic surgery/COVID-19 group has displayed signs of the disease.

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