Surgical Protocol in a West China Day Surgery Center During the COVID-19 Pandemic: Practice and Experience

Background. Despite the danger of infection during the outbreak of the 2019 novel coronavirus (COVID-19) in Wuhan, many patients still need surgical treatment. Most elective surgeries were delayed because of the public health emergency. However, when patients have life-threatening emergencies or illnesses, surgeries are often needed as soon as possible. Moreover, due to hospital overcrowding during the COVID-19 outbreak, healthcare professionals initially struggled to address the issue due to a lack of experience. This is especially true for day surgery centers with higher patient mobility. Methods. We remodeled pathways to separate patients and medical personnel to minimize the COVID-19 infection rate. Further, strategies for medical staff education and potential patient education, ward disinfection and maintenance, setup with 3 more screening stations, patient and companion management, medical staff management, and perioperative management were implemented before starting elective day surgery. Results. From February 11 to March 11 in 2020, 202 day surgeries were performed. These were all elective surgeries and included ultrasound-guided Mammotome biopsy, endoscopic polypectomy, hernia repair, pediatric surgeries, cholecystectomy, choledochoscopy, radical mastectomy, percutaneous transhepatic cholangial drainage, liver biopsy, video-assisted thoracoscopic surgery, laparoscopic resection of colon cancer, colostomy apotheosis, and varicose vein surgery. On days 7, 14, and 30 after discharge, no postoperative complications were reported or infection of COVID-19 cases was reported. Conclusions. Using scientific and well-designed protocols, day surgery can ensure quality surgical care with while ensuring medical safety during the COVID-19 outbreak. These protocols may also be applied to other surgical departments in China.

A rare and unusual cause of mammographic calcification in the breast

Clinical questionA 45-year-old woman is found, on family history screening, to have calcification within the upper outer quadrant of her right breast. A diagnostic mammotome biopsy was performed. Review the interactive digital slide and consider your diagnosis and appropriate management.What is your diagnosis?Collagenous spherulosisFlat epithelial atypia with psammomatous calcificationLiesegang rings with lactational changesParasitic infectionSpheroid type amyloid