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3.
Br J Surg ; 108(10): 1162-1180, 2021 10 23.
Article in English | MEDLINE | ID: covidwho-1462296

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence. METHODS: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. RESULTS: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. CONCLUSION: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.


Subject(s)
COVID-19/prevention & control , Perioperative Care/trends , Practice Patterns, Physicians'/trends , Surgical Procedures, Operative/trends , Adult , Biomedical Research/organization & administration , COVID-19/diagnosis , COVID-19/economics , COVID-19/epidemiology , Education, Medical, Graduate/methods , Education, Medical, Graduate/trends , Female , Global Health , Health Resources/supply & distribution , Health Services Accessibility/trends , Humans , Infection Control/economics , Infection Control/methods , Infection Control/standards , International Cooperation , Male , Middle Aged , Pandemics , Perioperative Care/education , Perioperative Care/methods , Perioperative Care/standards , Practice Patterns, Physicians'/standards , Surgeons/education , Surgeons/psychology , Surgeons/trends , Surgical Procedures, Operative/education , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/standards
4.
Medicine (Baltimore) ; 100(33): e26760, 2021 Aug 20.
Article in English | MEDLINE | ID: covidwho-1367077

ABSTRACT

ABSTRACT: The present study reported early clinical outcomes and perioperative precautions for medical staffs during joint arthroplasty procedures in SARS-CoV-2-infected patients.The medical records of 8 patients with SARS-CoV-2 infection who underwent joint arthroplasty from January 19 to September 24, 2020 were retrospectively reviewed and analyzed. Perioperative precautions and follow-up (time length varies from 6 month to 13 months, 11 months in average) for SARS-CoV-2 infection of medical staffs were reported.All patients recovered well from both the primary disease and SARS-CoV-2 infection. Significant improved Visual analogue scale was observed with no major complications or recurrence of the COVID-19 at discharge. There was no evidence indicating SARS-CoV-2 infection in any health providers.Elective joint arthroplasties for patients in recovery period of SARS-CoV-2 infection could be continued under comprehensive preoperative evaluation and appropriate medical protection. For patients with currently confirmed or highly suspected COVID-19, the operation should be carried out only if it was essential.


Subject(s)
Arthroplasty, Replacement, Hip , COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Medical Staff, Hospital , Perioperative Care/methods , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/adverse effects , Clinical Protocols , Female , Hip/diagnostic imaging , Humans , Male , Middle Aged , Pandemics , Personal Protective Equipment , Postoperative Care , Postoperative Complications , Retrospective Studies , SARS-CoV-2 , Treatment Outcome , Workflow
5.
Ann Thorac Surg ; 112(5): 1707-1715, 2021 11.
Article in English | MEDLINE | ID: covidwho-1347031

ABSTRACT

EXECUTIVE SUMMARY: Cardiothoracic surgical patients are at risk of increased coronavirus disease severity. Several important factors influence the administration of the coronavirus disease vaccine in the perioperative period. This guidance statement outlines current information regarding vaccine types, summarizes recommendations regarding appropriate timing of administration, and provides information regarding side effects in the perioperative period for cardiac and thoracic surgical patients.


Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/prevention & control , Cardiovascular Diseases/surgery , Perioperative Care/methods , Practice Guidelines as Topic , Thoracic Surgical Procedures , Vaccination/standards , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Comorbidity , Humans , Pandemics
10.
Plast Surg Nurs ; 41(1): 36-39, 2021.
Article in English | MEDLINE | ID: covidwho-1218019

ABSTRACT

On March 11, 2020, the World Health Organization declared COVID-19 to be a pandemic, challenging health care systems all over the world. National health care systems have reorganized to cope with the disease. Surgical services departments around the world have been affected and elective surgical procedures have been postponed to conserve medical resources. When a patient with COVID-19 requires an urgent microsurgical free flap due to trauma or a tumor, personnel from the health care facility must have a protocol in place to follow for the patient's care and follow-up. In this article, we present our protocol for patients with COVID-19 requiring reconstructive microsurgery.


Subject(s)
COVID-19/prevention & control , Free Tissue Flaps/transplantation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Microsurgery/methods , Perioperative Care/methods , Reconstructive Surgical Procedures/methods , Aftercare/methods , Aftercare/standards , COVID-19/complications , COVID-19/transmission , Clinical Protocols , Hospitals, University , Humans , Infection Control/standards , Microsurgery/standards , Perioperative Care/standards , Reconstructive Surgical Procedures/standards , Spain
13.
Anticancer Res ; 41(4): 2193-2195, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1168334

ABSTRACT

BACKGROUND/AIM: Since January 2020, coronavirus disease (COVID-19) cases have been confirmed in Japan, and the number of patients with COVID-19 has been increasing. Two emergency declarations have been made previously and one is currently in effect. Based on our experience of a situation that could affect cancer treatment, this study retrospectively examined the correlation between perioperative anticancer therapy and COVID-19 incidence in patients with breast cancer. PATIENTS AND METHODS: Patients who underwent perioperative anticancer therapy for breast cancer at our hospital from February 2020 to February 2021 were included in this study. The presence or absence of COVID-19, timing of anticancer drug initiation, and clinical data were collected. RESULTS: No cases of COVID-19 were diagnosed in patients receiving perioperative anticancer therapy at our hospital. CONCLUSION: Regimen modification, active use of supportive care, and patient lifestyle were factors reducing the incidence of COVID-19.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Breast Neoplasms , COVID-19/epidemiology , Perioperative Care/methods , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant/statistics & numerical data , Combined Modality Therapy , Female , Humans , Immunocompromised Host , Incidence , Japan/epidemiology , Middle Aged , Neoadjuvant Therapy/statistics & numerical data , Perioperative Care/adverse effects , Perioperative Care/statistics & numerical data , Retrospective Studies , Risk Factors , SARS-CoV-2/physiology
15.
World J Emerg Surg ; 16(1): 14, 2021 03 22.
Article in English | MEDLINE | ID: covidwho-1146830

ABSTRACT

BACKGROUND: Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers. METHOD: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology. RESULTS: Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts' opinion. CONCLUSIONS: The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment. We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient. The management of COVID-19 surgical patients is multidisciplinary. If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.


Subject(s)
COVID-19/prevention & control , Infection Control/standards , Perioperative Care/standards , Surgical Procedures, Operative/standards , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing/methods , COVID-19 Testing/standards , Emergencies , Global Health , Humans , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Laparoscopy/methods , Laparoscopy/standards , Pandemics , Perioperative Care/methods , Personal Protective Equipment , Surgical Procedures, Operative/methods
18.
Dig Surg ; 38(2): 158-165, 2021.
Article in English | MEDLINE | ID: covidwho-1105564

ABSTRACT

BACKGROUND: This survey aimed to register changes determined by the COVID-19 pandemic on pancreatic surgery in a specific geographic area (Germany, Austria, and Switzerland) to evaluate the impact of the pandemic and obtain interesting cues for the future. METHODS: An online survey was designed using Google Forms focusing on the local impact of the pandemic on pancreatic surgery. The survey was conducted at 2 different time points, during and after the lockdown. RESULTS: Twenty-five respondents (25/56) completed the survey. Many aspects of oncological care have been affected with restrictions and delays: staging, tumor board, treatment selection, postoperative course, adjuvant treatments, outpatient care, and follow-up. Overall, 60% of respondents have prioritized pancreatic cancer patients according to stage, age, and comorbidities, and 40% opted not to operate high-risk patients. However, for 96% of participants, the standards of care were guaranteed. DISCUSSION/CONCLUSIONS: The first wave of the COVID-19 pandemic had an important impact on pancreatic cancer surgery in central Europe. Guidelines for prompt interventions and prevention of the spread of viral infections in the surgical environment are needed to avoid a deterioration of care in cancer patients in the event of a second wave or a new pandemic. High-volume centers for pancreatic surgery should be preferred and their activity maintained. Virtual conferences have proven to be efficient during this pandemic and should be implemented in the near future.


Subject(s)
COVID-19/prevention & control , Health Services Accessibility/trends , Pancreatectomy/trends , Pancreatic Neoplasms/surgery , Practice Patterns, Physicians'/trends , Aftercare/methods , Aftercare/standards , Aftercare/trends , Attitude of Health Personnel , COVID-19/epidemiology , Europe/epidemiology , Health Care Surveys , Health Services Accessibility/standards , Humans , Infection Control/methods , Infection Control/trends , Neoplasm Staging , Pancreatectomy/standards , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/pathology , Pandemics , Patient Acceptance of Health Care , Perioperative Care/methods , Perioperative Care/standards , Perioperative Care/trends , Practice Guidelines as Topic , Practice Patterns, Physicians'/standards , Time-to-Treatment/standards , Time-to-Treatment/trends
19.
Surg Infect (Larchmt) ; 22(8): 818-827, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1104786

ABSTRACT

Background: As the coronavirus disease-2019 (COVID-19) pandemic continues globally, high numbers of new infections are developing nationwide, particularly in the U.S. Midwest and along both the Atlantic and Pacific coasts. The need to accommodate growing numbers of hospitalized patients has led facilities in affected areas to suspend anew or curtail normal hospital activities, including elective surgery, even as earlier-affected areas normalized surgical services. Backlogged surgical cases now number in the tens of millions globally. Facilities will be hard-pressed to address these backlogs, even absent the recrudescence of COVID-19. This document provides guidance for the safe and effective resumption of surgical services as circumstances permit. Methods: Review and synthesis of pertinent international peer-reviewed literature, with integration of expert opinion. Results: The "second-wave" of serious infections is placing the healthcare system under renewed stress. Surgical teams likely will encounter persons harboring the virus, whether symptomatic or not. Continued vigilance and protection of patients and staff remain paramount. Reviewed are the impact of COVID-19 on the surgical workforce, considerations for operating on a COVID-19 patient and the outcomes of such operations, the size and nature of the surgical backlog, and the logistics of resumption, including organizational considerations, patient and staff safety, preparation of the surgical candidate, and the role of enhanced recovery programs to reduce morbidity, length of stay, and cost by rational, equitable resource utilization. Conclusions: Resumption of surgical services requires institutional commitment (including teams of surgeons, anesthesiologists, nurses, pharmacists, therapists, dieticians, and administrators). Structured protocols and equitable implementation programs, and iterative audit, planning, and integration will improve outcomes, enhance safety, preserve resources, and reduce cost, all of which will contribute to safe and successful reduction of the surgical backlog.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/standards , Elective Surgical Procedures/standards , Guidelines as Topic , Infection Control/standards , Pandemics/prevention & control , Perioperative Care/standards , COVID-19/epidemiology , Health Facilities/standards , Humans , Infection Control/methods , Perioperative Care/methods , SARS-CoV-2 , Societies, Medical
20.
AORN J ; 112(3): 217-224, 2020 09.
Article in English | MEDLINE | ID: covidwho-1103269

ABSTRACT

The novel coronavirus SARS-CoV-2 first appeared in Wuhan, China, in December 2019 and led to the Coronavirus Disease 2019 (COVID-19), which quickly spread globally. Protocols for surgical patients with COVID-19 were lacking, particularly for pregnant women undergoing cesarean deliveries. Perioperative nurses at Tongji Hospital in Wuhan retrospectively analyzed the perioperative nursing process, including OR preparation, intraoperative care, and OR cleanup, for women with COVID-19 undergoing cesarean deliveries. Preparation involved altering the layout of the surgical suite, educating staff members, providing personal protective equipment, and creating new in-house guidelines to help protect personnel and patients. This article describes how perioperative personnel strategized to prevent the transmission of COVID-19 in the OR and presents a multiple-case summary of six pregnant patients with COVID-19 who underwent cesarean deliveries at Tongji Hospital in January and February 2020.


Subject(s)
Cesarean Section/statistics & numerical data , Coronavirus Infections/therapy , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Perioperative Care/methods , Pneumonia, Viral/therapy , Pregnancy Outcome/epidemiology , Betacoronavirus , COVID-19 , China , Coronavirus Infections/surgery , Female , Humans , Pandemics , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/surgery , Pregnancy , Pregnancy Complications, Infectious/therapy , SARS-CoV-2
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