Coronavirus and surgery
- PDF / 193,046 Bytes
- 3 Pages / 595 x 842 pts (A4) Page_size
- 22 Downloads / 195 Views
Eur Surg https://doi.org/10.1007/s10353-020-00647-y
Coronavirus and surgery UA Khan · MA Gok
Received: 15 May 2020 / Accepted: 12 June 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
The coronavirus pandemic has changed our world for the foreseeable future. All countries throughout the world are struggling to cope with the devastating effects of the pandemic, both on human life and also on economics. As far as health systems all over the world are concerned, there have also been devastating effects. All routine operations have been cancelled. All endoscopies—whether for cancer diagnosis or surveillance—have been postponed for the foreseeable future. Accident and emergency (A & E) department attendances have fallen significantly since the COVID19 lockdown in Britain. The recorded drop prompted the Royal College of Emergency Medicine to advice the public not to be frightened of going to the A & E. The figures from the Emergency Department Syndromic Surveillance System for England showed 89,584 attendances in the week after the lockdown was announced on March 23, 2020, a 25% drop on 120,356 in the previous week [1]. Another problem is the shortage of personal protective equipment (PPE) world over. Doctors, nurses, carers and other healthcare workers are working under considerable constraints. Royal colleges, surgical associations and Public Health England (PHE) have been working together to produce the most sensible and safe guidance. Here we look at the treatments that must continue, treatments which can be put on hold and also the uses of PPE. U. Khan () · M. Gok Macclesfield District General Hospital, East Cheshire NHS Trust, Victoria Road, Macclesfield, East Cheshire, SK10 3BL, England, UK [email protected] M. Gok [email protected]
K
Essential and urgent cancer treatments must continue [2]. Cancer specialists should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time. Urgent consideration should be given to consolidating cancer surgery in a COVID-free hub, with centralised triage to prioritise patients based on clinical need. Patients over 70 are at an increased risk, and also those over 65 with chronic respiratory diseases such as moderate to severe asthma, COPD, emphysema, bronchitis, chronic heart disease, chronic kidney disease, hepatitis, and chronic neurological diseases such as motor neuron disease, multiple sclerosis, etc. [3]. Pregnant woman up to 28 weeks are also at a high risk, and so are diabetics and immunocompromised patients [3]. National guidance in the UK (23 March, 2020) proposed a system of prioritisation for cancer patients requiring surgery (Table 1; [2, 4]). Priority level 1a are emergency operations needed within 24 h to save lives, whereas priority level 1b are urgent operations needed with 72 h. Priority level 2 consists of elective surgery/treatment with the expectation of cure needed within 4 weeks to save life/stop progression, taking into account symptoms and potential complications from lack of treatmen
Data Loading...
