SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic
SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic
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DOI：
10.1007/s00464-020-07565-w
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发表时间：
2020-04-22
影响因子：
3.1
通讯作者：
Pryor, Aurora
中科院分区：
文献类型：
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作者：
Francis, Nader;Dort, Jonathan;Pryor, Aurora
前所未有的COVID-19大流行影响了许多人的生活，并影响了全球的整个医疗系统。除了相当大的工作量挑战外，外科医生还面临着许多关于自身安全、实践和整体患者护理的不确定性。本指南是在短时间内起草的，旨在就2019冠状病毒病大流行期间与手术服务提供和微创手术安全相关的具体问题提供建议。虽然腹腔镜手术理论上可以导致血液传播病毒的雾化，但没有证据证实COVID-19就是这种情况。在考虑腹腔镜技术已证实的受益与雾化的潜在理论风险后，应做出该方法的最终决定。然而，为安全起见，应将冠状病毒视为具有类似雾化特性的冠状病毒，且手术室全体员工应在大流行期间的所有手术程序中使用个人防护设备（PPE），无论是否为已知或疑似COVID状态。在关闭、取出套管针、取出标本或转为开放前，应通过过滤系统安全排空气腹。在大流行期间进行的所有紧急内窥镜手术应被视为高风险，所有内窥镜工作人员必须使用PPE。
The unprecedented pandemic of COVID-19 has impacted many lives and affects the whole healthcare systems globally. In addition to the considerable workload challenges, surgeons are faced with a number of uncertainties regarding their own safety, practice, and overall patient care. This guide has been drafted at short notice to advise on specific issues related to surgical service provision and the safety of minimally invasive surgery during the COVID-19 pandemic. Although laparoscopy can theoretically lead to aerosolization of blood borne viruses, there is no evidence available to confirm this is the case with COVID-19. The ultimate decision on the approach should be made after considering the proven benefits of laparoscopic techniques versus the potential theoretical risks of aerosolization. Nevertheless, erring on the side of safety would warrant treating the coronavirus as exhibiting similar aerosolization properties and all members of the OR staff should use personal protective equipment (PPE) in all surgical procedures during the pandemic regardless of known or suspected COVID status. Pneumoperitoneum should be safely evacuated via a filtration system before closure, trocar removal, specimen extraction, or conversion to open. All emergent endoscopic procedures performed during the pandemic should be considered as high risk and PPE must be used by all endoscopy staff.