B De Simone1, E Chouillard1, S Di Saverio2, L Pagani3, M Sartelli4, W L Biffl5, F Coccolini6, A Pieri3, M Khan7, G Borzellino8, F C Campanile9, L Ansaloni10, F Catena11. 1. Centre Hospitalier Intercommunal Poissy/Saint-Germain-en-Laye, France. 2. University of Insubria, Varese, Italy. 3. Bolzano Central Hospital, Italy. 4. Macerata Hospital, Italy. 5. Scripps Memorial Hospital, La Jolla, CA, US. 6. University Hospital of Pisa, Italy. 7. Brighton and Sussex University Hospitals NHS Trust, UK. 8. San Giovanni Decollato-Andosilla Hospital, Civita Castellana, Italy. 9. University Hospital of Verona, Italy. 10. Bufalini Hospital, Cesena, Italy. 11. University Hospital of Parma, Italy.
Abstract
INTRODUCTION: Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. METHODS: A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. FINDINGS: Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. CONCLUSIONS: During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.
INTRODUCTION: Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. METHODS: A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. FINDINGS: Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. CONCLUSIONS: During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.
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Authors: Belinda De Simone; Elie Chouillard; Massimo Sartelli; Walter L Biffl; Salomone Di Saverio; Ernest E Moore; Yoram Kluger; Fikri M Abu-Zidan; Luca Ansaloni; Federico Coccolini; Ari Leppänemi; Andrew B Peitzmann; Leonardo Pagani; Gustavo P Fraga; Ciro Paolillo; Edoardo Picetti; Massimo Valentino; Emmanouil Pikoulis; Gian Luca Baiocchi; Fausto Catena Journal: World J Emerg Surg Date: 2021-03-22 Impact factor: 5.469
Authors: Belinda de Simone; Fausto Catena; Salomone Di Saverio; Massimo Sartelli; Fikri M Abu-Zidan; Mauro Podda; Walter L Biffl; Luca Ansaloni; Federico Coccolini; Ernest E Moore; Yoram Kluger; Carlos Augusto Gomes; Ferdinando Agresta; Elie Chouillard Journal: Turk J Surg Date: 2021-12-31
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Authors: Eloy Maldonado-Marcos; Cèlia Caula-Freixa; Pere Planellas-Giné; José Ignacio Rodríguez-Hermosa; Santiago López-Ben; Olga Delisau-Puig; Antoni Codina Cazador Journal: Cir Esp (Engl Ed) Date: 2020-08-04
Authors: Francesco A Ciarleglio; Marta Rigoni; Liliana Mereu; Cai Tommaso; Alessandro Carrara; Gianni Malossini; Saverio Tateo; Giuseppe Tirone; Truls E Bjerklund Johansen; Pier Paolo Benetollo; Antonio Ferro; Giovanni Maria Guarrera; Mario Grattarola; Giandomenico Nollo; Alberto Brolese Journal: World J Emerg Surg Date: 2021-07-13 Impact factor: 5.469