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Informed consent and a risk-based approach to oncologic surgery in a cancer center during the COVID-19 pandemic #MMPMID33684245
de Cassio Zequi S; Franca Silva ILA; Duprat JP; Coimbra FJF; Gross JL; Vartanian JG; Makdissi FBA; Leite FPM; Costa WHD; Yazbek G; Joaquim EHG; Bussolotti RM; Caruso P; de Avila Lima MC; Nakagawa SA; Aguiar S Jr; Baiocchi G; Lopes A; Kowalski LP
J Surg Oncol 2021[May]; 123 (8): 1659-1668 PMID33684245show ga
BACKGROUND: Cancer patients configure a risk group for complications or death by COVID-19. For many of them, postponing or replacing their surgical treatments is not recommended. During this pandemic, surgeons must discuss the risks and benefits of treatment, and patients should sign a specific comprehensive Informed consent (IC). OBJECTIVES: To report an IC and an algorithm developed for oncologic surgery during the COVID-19 outbreak. METHODS: We developed an IC and a process flowchart containing a preoperative symptoms questionnaire and a PCR SARS-CoV-2 test and described all perioperative steps of this program. RESULTS: Patients with negative questionnaires and tests go to surgery, those with positive ones must wait 21 days and undergo a second test before surgery is scheduled. The IC focused both on risks and benefits inherent each surgery and on the risks of perioperative SARS-CoV-2 infections or related complications. Also, the IC discusses the possibility of sudden replacement of medical staff member(s) due to the pandemic; the possibility of unexpected complications demanding emergency procedures that cannot be specifically discussed in advance is addressed. CONCLUSIONS: During the pandemic, specific tools must be developed to ensure safe experiences for surgical patients and prevent them from having misunderstandings concerning their care.