The Invisible Part of The Iceberg in Covid-19 Pandemic: Asymptomatic Cases and Anesthesiologists’ Protective Approaches-Knowledge Levels

Abstract

Introduction: According to studies asymptomatic COVID-19 cases are thought to be quite high in the community. Their exact number is unknown. Considering that there are false negative results in PCR tests, it should always be considered that all asymptomatic patients may also be COVID-19 positive. We aimed to evaluate the protective and preventive approaches, knowledge levels and technical facilities of anesthesiologists in the perioperative process, after recognizing the COVID-19 alarm symptoms as much as possible and isolating the suspected cases during the pandemic.Methods: A survey form was prepared to evaluate the awareness of anesthesiologists about asymptomatic cases, their protective-preventive approaches, knowledge levels and technical facilities. The form was created online, with the aim of reaching more participants. The survey form was sent to the participants via e-mail and WhatsApp. Those who did not fill more than 90% of the survey questions were excluded from the study.Results: According to our study within 100 participants, 95 participants indicated that they question their patients regarding presence of COVID-19-related symptoms and contact history; 86 participants indicated that they evaluate presence of lymphopenia; 78 participants indicated they evaluate CRP levels; 76 participants indicated that they evaluate chest radiography findings; 75 participants indicated evaluation of D-Dimer levels; 74 participants indicated evaluation of ferritin values and 73 participants indicated evaluation of thorax CT findings for a correlation with COVID-19.Conclusion: The current tests for SARS-CoV-2 are not sensitive enough to rule out the possibility of asymptomatic carriers entering the operating room. It is important to keep in mind the steps that include detecting the patients with high risk of infection even if their PCR tests are negative.

Özet

Amaç: Bu çalışmada alt dudak kanseri tanısı alan hastalara uygulanan cerrahi tedavi seçenekleri tartışılmıştır. Materyal ve Metod: Çukurova Üniversitesi Tıp Fakültesi Plastik, Rekonstrüktif ve Estetik Cerrahi Kliniğinde 2016-2020 yılları arasında alt dudak kanseri tanısı alan 45 hasta retrospektif olarak incelenmiştir. Bulgular: Hastaların yaş ortalaması 57,9 yıl, %86,6’sı erkek %13,4’ü kadındı. %91,1’i SCC, %8,9’u BCC’ydi. Cerrahi tedavide 16 hastaya eksizyon-primer onarım, 22 hastaya lokal ve yanak ilerletme flebi, 3 hastaya pektoral flep ve 4 hastaya serbest flepler ile onarım yapıldı. Sonuç: Alt dudak tümörlerinde erken evrelerde cerrahi tedavi ile kür şansı oldukça yüksektir. İleri evre lezyonlarda da cerrahi algoritmaya uygun olarak ve hastaya göre planlama yaparak fonksiyonel ve estetik olarak iyi sonuçlar elde etmek mümkündür.