Perioperative Cancer Care in the Context of Limited Resources during the COVID-19 Pandemic: Brazilian Society of Surgica
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CONTINUING EDUCATION– HEALTH SERVICES RESEARCH AND GLOBAL ONCOLOGY
Perioperative Cancer Care in the Context of Limited Resources during the COVID-19 Pandemic: Brazilian Society of Surgical Oncology Recommendations Reitan Ribeiro, MD1,2 , Alberto Julius Alves Wainstein, MD, PhD1,3, Heber Salvador de Castro Ribeiro, MD, PhD1,4, Rodrigo Nascimento Pinheiro, MD, MsC1,5, and Alexandre Ferreira Oliveira, MD, PhD6,7 1
COVID-19 Crisis Committee, Brazilian Society of Surgical Oncology (BSSO), Rio de Janeiro, Brazil; 2Department of Surgical Oncology, Erasto Gaertner Hospital, Curitiba, Brazil; 3School of Medicine, Faculdade Cieˆncias Me´dicas de Minas Gerais, Belo Horizonte, Brazil; 4Abdominal Surgery Department, A.C. Camargo Cancer Center, Sa˜o Paulo, Brazil; 5 Department of Surgical Oncology, Base Institute Hospital, Brası´lia, Brazil; 6Brazilian Society of Surgical Oncology (BSSO), Rio de Janeiro, Brazil; 7Department of Surgery, Juiz de Fora Federal University, Juiz de Fora, Brazil
ABSTRACT Background. As the COVID-19 pandemic moves from rich to poor nations, the healthcare systems of developing countries have to deal with this extra burden. As cancer care cannot stop and surgery is the main mechanism for cure and palliation, it is important to provide safe and rational access to cancer surgery during the COVID-19 pandemic. Methods. From April 1st to May 1st, the committee of the Brazilian Society of Surgical Oncology (BSSO) was responsible for reviewing the literature and writing recommendations for perioperative cancer care in the context of limited resources during the pandemic. The recommendations were submitted to the BSSO board of directors. The orientations that were not consensual were removed and the suggestions were added to the text. From May 15 to 30th, the committee revised the recommendations, aligned them with the objectives of the work and standardize the text.
Society of Surgical Oncology 2020 First Received: 6 June 2020 Accepted: 18 August 2020 R. Ribeiro, MD e-mail: [email protected]
Discussion. The rational use of resources to reduce the risk of surgical cancer patients being operated on during the incubation period of a corona virus infection is important in this context. Prevalence of corona virus in the region, the need for surgery, surgical complexity, patient age and comorbidities, and availability of corona virus testing are central aspects in this matter and are discussed. Conclusions. We present a protocol, focused on the patients’ outcomes, for safe and rational use of resources to reduce the risk of surgical cancer patients being operated on during the virus incubation period, in the context of areas with limited resources.
As the coronavirus disease 2019 (COVID-19) pandemic moves from rich to poor nations, the health care systems of developing countries, normally equipped to work with limited resources, have to deal with this extra burden. Even developed countries have to temporarily manage, in the context of limited resources, and this may happen again in the future. As in a
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