Urological Surgeries During Exit from National Lockdown During COVID-19 Pandemic
- PDF / 281,990 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 105 Downloads / 168 Views
LETTER TO EDITOR
Urological Surgeries During Exit from National Lockdown During COVID-19 Pandemic Devanshu Bansal 1 & Samit Chaturvedi 1 & Anant Kumar 1 Received: 29 June 2020 / Accepted: 15 August 2020 # Association of Surgeons of India 2020
Dear Editor In Chief The first case of coronavirus disease (COVID-19) in India was reported on 30 January 2020 and the government declared a nationwide lockdown on 25 March 2020 [1]. However, a lockdown is not a cure and surgical management of non-COVID urologic illnesses cannot be indefinitely postponed [2]. Recommendations to restart surgical care are essential as the lockdown is eased. Partial utilization of resources should initially be done to spare for a sudden increase in demand due to surge in cases. Surgeries that have been postponed once during lockdown (for 3 or 6 months) should not be re-postponed. Guidelines have previously proposed postponement of uro-oncologic surgeries by 3–6 months for small renal masses, low-risk nonmuscle invasive bladder cancer, low-risk upper tract urothelial cancers, low–high-risk localized prostate cancer, and early penile cancer [3, 4]. Analysis of our case load (unpublished) of oncologic surgeries and renal transplants performed during lockdown compared with a similar duration in 2019 showed a decline of 87.7% and 70.7% respectively (Fig. 1). Cancer care for patients previously postponed should reinitiate. Key safety concerns include older age, increased comorbidities, complex nature of surgeries, and more complicated hospital stay [5]. Oncological patients should be encouraged to come forward for care and their scheduling done as per severity and urgency of their disease. Semi* Anant Kumar [email protected] Devanshu Bansal [email protected] Samit Chaturvedi [email protected] 1
Department of Urology, Renal Transplant, Robotics and Uro-oncology, Max Superspecialty Hospital, Saket, New Delhi 110017, India
urgent live renal transplants like lack of secure vascular access and for those not doing well on dialysis should be allowed [6]. All precautions should be taken to reduce exposure of healthy donor in hospital during investigations [7]. Prolonged prohibition on renal transplantation is likely to have a significant adverse effect on quality of life and survival of recipients. Benign urologic conditions can be divided into three categories (Table 1), and may have significant detrimental effect on quality of life of patients. Unfortunately, this aspect of treatment has not been adequately addressed in studies. While scheduling surgeries, a tiered system as proposed by us may be followed, so that patients who have been postponed once are able to get the required care (Table 1). Once planned for surgery, every patient should be screened for symptoms and tested for COVID-19. COVID-19-positive patients should be managed in a different dedicated ward and operation theatre or sent to a designated COVID-19 hospital. It should be realized that these tests have a high false negative rate (median 38% on the day of symptom onset), so a
Data Loading...
