The outbreak of the novel coronavirus pneumonia (NCP) has become a public health emergency in China. Chinese authorities and health agencies had devoted great efforts to control this disease. As surgeons specialized in the treatment of gastrointestinal tumors, we should always be aware of the prevention for NCP and incorporate this awareness into every detail of clinical practice. For the patients with gastrointestinal tumors, pre-admission screening should be done in order to rule out NCP. Real-time RT-PCR panel and chest CT scan should be conducted for patients with fever (>37.3℃), travel history to Hubei Province within 14 days, or contact history with residents from Wuhan district within 14 days. Prevention measures for both medical staffs and the screen-negative admitted patients should also be enhanced because false negative is possible. Medical instruments should be properly discarded or disinfected according to standardized procedures established by the local center for disease control and prevention (CDC). Surgical operation should be reduced at a minimal level to prevent cross infection in this special period.Surgical intervention for benign tumor should be postponed. For malignant tumor, multidisciplinary therapy (MDT) is recommended and non-surgical anti-tumor therapy should be selected with higher priority. Neoadjuvant therapy is highly recommended for gastrointestinal cancer at advanced stages that meet the indications of NCCN guideline (gastric cancer T stage ≥ 2/rectal cancer T stage ≥ 3/unresectable colon cancer). Gastric or esophagogastricjunction (EGJ) malignant tumor with obstruction can be managed with gastric tube decompression or stent placement to relieve the symptoms. Transnasal enteral feeding tube intubation/percutaneous endoscopic gastrostomy could be adopted to ensure enteral nutrition supply. For colorectal malignancy with simple intestinal obstruction, stent placement can achieve a high success rate, which not only helps avoid emergency surgery, but also creates a better condition for subsequent surgery. Transcatheter arterial embolization for hemostasis is an alternative choice for gastrointestinal tumor with bleeding. However, emergency operation still must be performed for patients with acute uncontrolled bleeding, obstruction or after other alternative treatment measures fail. All cases with suspicious or confirmed with NCP must be reported to the local CDC department. All invasive intervention must be performed in a designated isolation area. Tertiary prevention measure must be adopted for all anesthetists with additional face mask or medical goggle protection to prevent respiratory droplet transmission. Preventive enterostomy is preferable in lower digestive tract surgery. Thoroughly disinfecting the operating room after surgery is necessary. Fever after surgery must be carefully differentiated whether it's caused by post-surgery abdominal infection/inflammation or NCP. Single-room isolation and related examinations should be performed according to the standard procedures. We believe that with the unprecedentedly joint efforts of doctors and patients, we will eventually win this war against NCP.
当前，我国新型冠状病毒肺炎（简称"新冠肺炎"）的疫情形势严峻，全国医护人员都义不容辞地肩负起了抗击疫情的重任。作为胃肠外科医师，我们应积极学习新冠肺炎的相关知识，科学应对，把防疫的意识渗透到临床工作的每个诊疗细节和临床操作中去。对于胃肠肿瘤患者，首先应做好入院前筛查，肺部CT应作为常规检查项目。经过严密筛查的患者入院后术前检查时需加强防护措施，包括医护人员的自我防护；诊疗过的器械或物品应妥善丢弃，或按规范流程进行消毒，严防交叉感染。对于胃肠道良性肿瘤，如无合并明显出血或梗阻，不建议在这个非常时期进行手术治疗，可待疫情高峰期过后择期手术。对于进展期胃肠恶性肿瘤患者，建议经过多学科联合会诊（MDT），如果符合新辅助治疗指征，应优先选择新辅助治疗而推迟手术。胃肠道肿瘤合并梗阻或出血的病例可考虑通过内镜或介入治疗解除梗阻或止血；若肿瘤合并出血保守治疗及内镜治疗无效，可尝试于介入下进行选择性血管栓塞；合并梗阻但没有合并腹膜炎者，肠道支架置入具有较高的解除梗阻成功率，大部分患者可免于急诊手术。对于胃窦肿瘤合并胃潴留、食管胃结合部肿瘤合并食管梗阻的患者，可留置胃管和空肠营养管，进行减压和营养支持以缓解症状，为限期手术创造更好的身体情况。对于确实需要手术、且疑似或确诊新冠肺炎患者，在向医院、疾控中心进行报备的前提下，最好转至定点医院诊治，或于专门隔离病区进行术前准备、专门的通道进行转运以及专门的感染手术室进行手术；麻醉医师在三级预防的基础上注意配戴防护面罩进行气管插管及拔管，以防飞沫喷溅。对于下消化道手术，应更积极行预防性肠造口。术后对手术间进行彻底消毒。对于手术后发热患者，应与新冠肺炎相鉴别，若伴咳嗽、咳痰者，应按疑似新冠肺炎病例的标准进行单间隔离和相关检查。相信通过医患双方的共同努力，取得这场防疫战争的胜利将指日可待！.
Keywords: Gastrointestinal tumor, treatment strategy; Multidisciplinary therapy; Novel coronavirus pneumonia (NCP).
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