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Methodology for the Triage of Urologic Surgical Cases in the Setting of a Pandemic (preprint)
researchsquare; 2020.
Preprint
in English
| PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-98427.v1
ABSTRACT
Purpose:
The COVID-19 pandemic forced our healthcare system in the Bronx, New York to cancel nearly all surgeries. With the possible second wave approaching, we developed a framework for the prioritization of Urologic surgeries that can be used as a model for those experiencing surges elsewhere.Methods:
Each surgeon in the department was asked to rank their cancelled surgeries by priority (Level 1 – least urgent; Level 2 – moderately urgent; Level 3 – most urgent). A committee of urologists assigned a subclass to Level 3 and 2 cases (3a – least urgent; 3b – moderately urgent; 3c – most urgent; 2a – lower priority; 2b – higher priority). The committee then reviewed cases by urgency to arrive on a final priority ranking.Results:
A total of 478 total cases were categorized 250 Level 1, 130 Level 2, 98 Level 3 (73 adult, 25 pediatric). Level 3c involved renal cell carcinoma ≥ T2b, high-grade bladder urothelial carcinoma, adrenal mass/cancer > 6 cm, testicular cancer requiring radical orchiectomy, and penile cancer. Level 3b involved T2a renal masses requiring nephrectomy; high-risk prostate cancer and symptomatic nephrolithiasis were classified as 3a. Level 2 included testicular cancer requiring retroperitoneal lymph node dissection and complicated benign prostatic hyperplasia. Surgeries for urologic reconstruction, erectile dysfunction, and incontinence were considered Level 1.Conclusions:
Our disease-specific approach to surgical rescheduling offers appropriate guidance for triaging Urologic surgeries. Our system can provide guidance to other institutions as COVID-19 surges in different regions and with the growing possibility of a second wave.
Full text:
Available
Collection:
Preprints
Database:
PREPRINT-RESEARCHSQUARE
Main subject:
Prostatic Hyperplasia
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Prostatic Neoplasms
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Testicular Neoplasms
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Urinary Incontinence
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Urinary Bladder Neoplasms
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Carcinoma, Renal Cell
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Nephrolithiasis
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COVID-19
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Erectile Dysfunction
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Neoplasms
Language:
English
Year:
2020
Document Type:
Preprint
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