Nosocomial infection with SARS-Cov-2 within Departments of Digestive Surgery.

INTRODUCTION: The COVID-19 pandemic imposed a drastic reduction in surgical activity in order to respond to the influx of hospital patients and to protect uninfected patients by avoiding hospitalization. However, little is known about the risk of infection during hospitalization or its consequences. The aim of this work was to report a series of patients hospitalized on digestive surgery services who developed a nosocomial infection with SARS-Cov-2 virus. METHODS: This is a non-interventional retrospective study carried out within three departments of digestive surgery. The clinical, biological and radiological data of the patients who developed a nosocomial infection with SARS-Cov-2 were collected from the computerized medical record. RESULTS: From March 1, 2020 to April 5, 2020, among 305 patients admitted to digestive surgery departments, 15 (4.9%) developed evident nosocomial infection with SARS-Cov-2. There were nine men and six women, with a median age of 62 years (35-68 years). All patients had co-morbidities. The reasons for hospitalization were: surgical treatment of cancer (n=5), complex emergencies (n=5), treatment of complications linked to cancer or its treatment (n=3), gastroplasty (n=1), and stoma closure (n=1). The median time from admission to diagnosis of SARS-Cov-2 infection was 34 days (5-61 days). In 12 patients (80%), the diagnosis was made after a hospital stay of more than 14 days (15-63 days). At the end of the follow-up, two patients had died, seven were still hospitalized with two of them on respiratory assistance, and six patients were discharged post-hospitalization. CONCLUSIONS: The risk of SARS-Cov-2 infection during hospitalization or following digestive surgery is a real and potentially serious risk. Measures are necessary to minimize this risk in order to return to safe surgical activity.

[Nosocomial infection with SARS-Cov-2 within departments of digestive surgery]. / Infection nosocomiale à SARS-Cov-2 dans les services de chirurgie digestive.

INTRODUCTION: The COVID-19 pandemic imposed a drastic reduction in surgical activity in order to respond to the influx of hospital patients and to protect uninfected patients by avoiding hospitalization. However, little is known about the risk of infection during hospitalization or its consequences. The aim of this work was to report a series of patients hospitalized on digestive surgery services who developed a nosocomial infection with SARS-Cov-2 virus. METHODS: This is a non-interventional retrospective study carried out within three departments of digestive surgery. The clinical, biological and radiological data of the patients who developed a nosocomial infection with SARS-Cov-2 were collected from the computerized medical record. RESULTS: From March 1, 2020 to April 5, 2020, among 305 patients admitted to digestive surgery departments, 15 (4.9 %) developed evident nosocomial infection with SARS-Cov-2. There were nine men and six women, with a median age of 62 years (35-68 years). All patients had co-morbidities. The reasons for hospitalization were: surgical treatment of cancer (n = 5), complex emergencies (n = 5), treatment of complications linked to cancer or its treatment (n = 3), gastroplasty (n = 1), and stoma closure (n = 1). The median time from admission to diagnosis of SARS-Cov-2 infection was 34 days (5-61 days). In 12 patients (80%), the diagnosis was made after a hospital stay of more than 14 days (15-63 days). At the end of the follow-up, two patients had died, seven were still hospitalized with two of them on respiratory assistance, and six patients were discharged post-hospitalization. CONCLUSIONS: The risk of SARS-Cov-2 infection during hospitalization or following digestive surgery is a real and potentially serious risk. Measures are necessary to minimize this risk in order to return to safe surgical activity.

Esophageal tissue engineering: Current status and perspectives.

Tissue engineering, which consists of the combination and in vivo implantation of elements required for tissue remodeling toward a specific organ phenotype, could be an alternative for classical techniques of esophageal replacement. The current hybrid approach entails creation of an esophageal substitute composed of an acellular matrix and autologous epithelial and muscle cells provides the most successful results. Current research is based on the use of mesenchymal stem cells, whose potential for differentiation and proangioogenic, immune-modulator and anti-inflammatory properties are important assets. In the near future, esophageal substitutes could be constructed from acellular "intelligent matrices" that contain the molecules necessary for tissue regeneration; this should allow circumvention of the implantation step and still obtain standardized in vivo biological responses. At present, tissue engineering applications to esophageal replacement are limited to enlargement plasties with absorbable, non-cellular matrices. Nevertheless, the application of existing clinical techniques for replacement of other organs by tissue engineering in combination with a multiplication of translational research protocols for esophageal replacement in large animals should soon pave the way for health agencies to authorize clinical trials.