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10.1016/j.jchirv.2020.03.007

http://scihub22266oqcxt.onion/10.1016/j.jchirv.2020.03.007
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suck abstract from ncbi


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pmid32834885
      J+Chir+Visc 2020 ; 157 (3 ): S6-S12
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  • Stratégie pour la pratique de la chirurgie digestive et oncologique en situation d?épidémie de COVID-19 #MMPMID32834885
  • Tuech JJ ; Gangloff A ; Di Fiore F ; Michel P ; Brigand C ; Slim K ; Pocard M ; Schwarz L
  • J Chir Visc 2020[Jun]; 157 (3 ): S6-S12 PMID32834885 show ga
  • The COVID-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery. Healthcare priorities and circuits are being modified. Emergency surgery is still a priority. Functional surgery is to be deferred. Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk. The question looms large in cancer surgery - go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery. For each type of cancer - colon, pancreas, oesogastric, hepatocellular carcinoma - morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time. Strategies can be proposed based on this comparison. For colonic cancers T1-2, N0, it is advisable to defer surgery. For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait. For rectal cancers T3-4 and /or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections. Most complex surgery with high morbidity and mortality - oesogastric, hepatic or pancreatic - is most often best deferred.
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