Surgical cancer care in the COVID-19 era: front line views and consensus

Rev Col Bras Cir. 2020:47:e20202601. doi: 10.1590/0100-6991e-20202601. Epub 2020 Jul 3.
[Article in Portuguese, English]

Abstract

Objective: to suggest a script for surgical oncology assistance in COVID-19 pandemic in Brazil.

Method: a narrative review and a "brainstorming" consensus were carried out after discussion with more than 350 Brazilian specialists and renowned surgeons from Portugal, France, Italy and United States of America.

Results: consensus on testing for COVID-19: 1- All patients to be operated should be tested between 24 and 48 before the procedure; 2- The team that has contact with sick or symptomatic patients should be tested; 3 - Chest tomography was suggested to investigate pulmonary changes. Consensus on protection of care teams: 1 - Use of surgical masks inside the hospitals. Use of N95 masks for all professionals in the operating room; 2 - Selection of cases for minimally invasive surgery and maximum pneumoperitoneal aspiration before removal of the surgical specimen; 2 - Optimization of the number of people in teams, with a minimum number of professionals, reducing their occupational exposure, the consumption of protective equipment and the circulation of people in the hospital environment; 3 - Isolation of contaminated patients. Priority consensus: 1- Construction of service priorities; 2 - Interdisciplinary discussion on minimally invasive or conventional pathways.

Conclusion: the Brazilian Society of Surgical Oncology (BSSO) suggests a script for coping with oncological treatment, remembering that the impoundment in the assistance of these cases, can configure a new wave of overload in health systems.

MeSH terms

  • Betacoronavirus*
  • Brazil / epidemiology
  • COVID-19
  • Consensus*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Health Personnel
  • Humans
  • International Cooperation
  • Italy
  • Lung / diagnostic imaging
  • Masks
  • Minimally Invasive Surgical Procedures
  • Neoplasms / complications
  • Neoplasms / surgery*
  • Occupational Exposure / prevention & control
  • Pandemics
  • Paris
  • Personal Protective Equipment
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Portugal
  • Preoperative Care
  • SARS-CoV-2
  • Specimen Handling
  • Washington