Hallym University Hangang Sacred Heart Hospital

While the world is being affected by COVID-19, Hallym University Dongtan Sacred Heart Hospital is conducting numerous surgical operations to save patients despite the risk of COVID-19 infection. Here is a case of surgery for a Korean patient in spite of her self-quarantine period who came back to Korea because she was unable to get treatment due to the COVID-19 pandemic in the U.S.

An emergency patient arrived at the emergency medical center of Hallym University Dongtan Sacred Heart Hospital in April. The 50-year-old female patient who had rectal cancer surgery in the U.S. and was suspected to have pelvic metastasis returned to Korea after hearing that it will take more than 3 months for her to get treatment due to the spread of COVID-19.

After being tested negative from a COVID-19 test conducted by health authorities shortly after her arrival, she wanted to see a doctor at the outpatient clinic in Korea but was unable to get treatment because of her mandatory two-week self-quarantine period. Suffering from severe pain from peritonitis, she was taken to the negative pressure isolation room at the ER of Dongtan Sacred Heart Hospital three days after her return.

Immediately after arriving at the ER, the second COVID-19 test was conducted but doctors could not wait for the results as her condition rapidly deteriorated. After figuring out the patient’s condition, Professor Jung Yon Kim of General Surgery at the hospital decided to perform emergency surgery and started the surgery at 2 am the next day after taking all preventive measures for infection control.

Unlike the usual, more medical personnel were deployed to minimize the risk of the infection. The patient was intubated in the negative pressure isolation room in the ICU and was transferred by the negative pressure transfer cart. All related healthcare workers wore Level-D Personal Protective Equipment (PPE) throughout the entire progress.

Although the surgery was over in 3 hours, the earliest record, the doctors and nurses in the PPE had to be in a state of tension during the surgery. No additional contact was occurred since all healthcare workers wore the protective clothing and followed hospital infection control guidelines. After the surgery, the operating room was closed for a while and disinfected.

Thanks to the successful operation, the patient overcame peritonitis and septicemia, making her daily life possible in a week. The second COVID-19 test was also confirmed negative. Following the hospital infection control guidelines, the patient stayed at the isolation ward for 14 days and tested negative once again from the COVID-19 test before being discharged safely.

“We decided to conduct the emergency surgery despite the infection risk because the mortality rate could go up to 48 percent if peritonitis was left unattended,” said Professor Jung Yon Kim and added, “Although the surgery itself was more difficult than performing colorectal cancer surgeries for ten times, it was greatly rewarding to see her recover and get healthy again.”

Hallym University Dongtan Sacred Heart Hospital has been treating many suspected COVID-19 patients, but so far, not a single case of infection was found. This was possible because the hospital made a thorough manual on infectious diseases based on its past experience of MERS outbreak in 2015 and has been implementing treatment according to the principles since the start of COVID-19.

Professor Dong Woo Shin of General Surgery who also serves as the chief of the department said, “Our physicians who perform surgery on suspected COVID-19 patients with high fever are even ready for being isolated and they do such surgeries in much more difficult conditions than usual.” He added, “Due to the fact that COVID-19 test takes about 24 hours, if the patient’s life is more likely to be critical while waiting for the result, we take the risk of the infection and push ahead with our medical treatment.”

By Hyun Ho Choi, Int’l Cooperation Team, HUMC (dullie1989@hallym.or.kr)