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A new study published in the International Journal of Surgery aimed to review the available recommendations published by general Surgery Societies and Health Institutions and evaluate the underlying Literature providing clinical and organizational guidelines for the management of a general surgery department during the COVID-19 pandemic.
This systematic 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.
Overall, 22 papers and statements were analyzed. It was noted that surgical societies have established criteria for triage and prioritization 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. Moreover, 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.
From the findings, it was inferred that 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.
Source: International Journal of Surgery. 2020 Jul;79:180-188. doi: 10.1016/j.ijsu.2020.05.061.