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1.
Journal de chirurgie viscerale ; 157(3):S6-S12, 2020.
Article | WHO COVID | ID: covidwho-728654

ABSTRACT

The COVID-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery Healthcare priorities and circuits are being modified Emergency surgery is still a priority Functional surgery is to be deferred Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk The question looms large in cancer surgery - go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery For each type of cancer - colon, pancreas, oesogastric, hepatocellular carcinoma - morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time Strategies can be proposed based on this comparison For colonic cancers T1-2, N0, it is advisable to defer surgery For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait For rectal cancers T3-4 and /or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections Most complex surgery with high morbidity and mortality - oesogastric, hepatic or pancreatic - is most often best deferred

2.
J Chir Visc ; 2020 Apr 21.
Article in French | MEDLINE | ID: covidwho-116280

ABSTRACT

The Covid-19 pandemic has markedly changed our practices. This article analyses the risks of contamination among healthcare professionals (HCPs) during laparoscopic surgery on patients with Covid-19. Harmful effects of aerosols from a pneumoperitoneum with the virus present have not yet been quantified. Measures for the protection of HCPs are an extrapolation of those taken during other epidemics. They must still be mandatory to minimise the risk of viral contamination. Protection measures include personal protection equipment for HCPs, adaptation of surgical technique (method for obtaining pneumoperitoneum, filters, preferred intracorporeal anastomosis, precautions during the exsufflation of the pneumoperitoneum), and organisation of the operating room.

3.
J Visc Surg ; 157(3S1): S7-S12, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-39755

ABSTRACT

The Covid-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery. Healthcare priorities and circuits are being modified. Emergency surgery is still a priority. Functional surgery is to be deferred. Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk. The question looms large in cancer surgery-go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery. For each type of cancer-colon, pancreas, oesogastric, hepatocellular carcinoma-morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time. Strategies can be proposed based on this comparison. For colonic cancers T1-2, N0, it is advisable to defer surgery. For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait. For rectal cancers T3-4 and/or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections. Most complex surgery with high morbidity and mortality-oesogastric, hepatic or pancreatic-is most often best deferred.


Subject(s)
Coronavirus Infections , Digestive System Diseases/surgery , Digestive System Neoplasms/surgery , Pandemics , Pneumonia, Viral , Health Services Needs and Demand , Humans , Laparoscopy , Postoperative Care , Practice Guidelines as Topic , Time-to-Treatment
5.
J Chir Visc ; 2020 Apr 06.
Article in French | MEDLINE | ID: covidwho-34835
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