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International guidelines and recommendations for surgery during Covid-19 pandemic: A Systematic Review.
Moletta, Lucia; Pierobon, Elisa Sefora; Capovilla, Giovanni; Costantini, Mario; Salvador, Renato; Merigliano, Stefano; Valmasoni, Michele.
  • Moletta L; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
  • Pierobon ES; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
  • Capovilla G; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy. Electronic address: giovanni.capovilla@aopd.veneto.it.
  • Costantini M; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
  • Salvador R; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
  • Merigliano S; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
  • Valmasoni M; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Clinica Chirurgica 3, Via Giustiniani 2, 35128, Padova, Italy.
Int J Surg ; 79: 180-188, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-397689
ABSTRACT

BACKGROUND:

During the COVID-19 pandemic, surgical departments were forced to re-schedule their activity giving priority to urgent procedures and non-deferrable oncological cases. There is a lack of evidence-based literature providing clinical and organizational guidelines for the management of a general surgery department. Aim of our study was to review the available recommendations published by general Surgery Societies and Health Institutions and evaluate the underlying Literature. MATERIALS AND

METHODS:

A review of the English Literature was conducted according to the AMSTAR and to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

RESULTS:

After eligibility assessment, a total of 22 papers and statements were analyzed. Surgical societies have established criteria for triage and prioritization in order to identify procedures that can be postponed after the pandemic and those that should not. Prioritization among oncologic cases represents a difficult task clinicians have to balance a possible delay in cancer diagnosis or treatment against the risk for a potential COVID-19 exposure. There is broad agreement among guidelines that indication to proceed with surgery should be discussed in virtual Tumor Boards taking into consideration alternative therapeutic approaches. Several guidelines deal with the role of laparoscopic surgery during the pandemic a tailored approach is currently suggested, with a case-by-case evaluation provided that appropriate personal protective equipment is available in order to minimize the potential risk of transmission. Finally, there is a considerable agreement in the published Literature concerning the management of the personnel during the peri- and intraoperative phase and on the technical advices regarding the induction, operative and recover maneuvers in COVID-19 cases.

CONCLUSIONS:

During COVID-19 pandemic, it is of paramount importance to face the emergency in the most effective and efficient manner, retrieving resources from non-essential settings and, at the same time, providing care to high priority non-COVID-19 related diseases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Surgery Department, Hospital / Coronavirus Infections / Pandemics Type of study: Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Surg Year: 2020 Document Type: Article Affiliation country: J.ijsu.2020.05.061

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Surgery Department, Hospital / Coronavirus Infections / Pandemics Type of study: Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Surg Year: 2020 Document Type: Article Affiliation country: J.ijsu.2020.05.061