Operational Directives for Surgical Practice During COVID-19 Era: An Analytical Approach-Based on Systematic Review of Published Recommendations

Résumé fourni par la source

Many surgical guidelines for COVID-19 rely on expert opinion leading to heterogeneity. We aim to systematically analyze published surgical recommendations in COVID-19 pandemic. Searches on PubMed and EMBASE of published surgical recommendations were conducted. Articles with recommendations on research questions covering at least two or more of five key domains were included. Eighty-six articles met inclusion criteria and were analysed. 43 (50.0%) articles recommended restricted outpatient clinics and tele-clinics. 35 (40.7%) guidelines recommended to delay elective oncosurgery in current pandemic. 17 (19.8%) recommended chemotherapy/radiotherapy if delay is inevitable. Majority recommended tiered framework for surgery (severity basis) (81.4%) and preoperative testing COVID-19 59 (68.6%). Limiting professional in operating rooms (72.1%), full protection even in surgery of low risk patient (60.5%), operating rooms with negative pressure ventilation (67.4%) were major recommendations. Precautions during laparoscopy surgery and use of smoke filters were recommended. Transitional facility with isolation for post-emergency surgery till COVID-19 test proved negative was highlighted by 26 articles and 11 highlighted careful assessment of postoperative fever and respiratory complications. Although there were heterogeneity majority recommendations were triage of surgical case, screening for COVID-19, adequate protection of healthcare professional, negative pressure ventilation in operating rooms and use of tele-clinics.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.