L'impact de la pandémie COVID19 sur l'anxiété des urologues français en formation : résultats d'une enquête nationale

Highlights The main advantage of minimally invasive techniques for the treatment of retrocaval ureter is less blood loss during surgery. Other advantages are shorter hospital stay, less postoperative pain and superior esthetic results. Pure laparoscopic treatment (as in our two cases) seems feasible and technically reliable with excellent functional outcome. Intracorporeal anastomosis of the ureter remains the main limiting factor.

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HighlightsRetroperitoneal schwannomas (RS) are rare, benign tumors that originate in the neural sheath.RS can be misdiagnosed preoperatively, especially when they stick to other structures (the adrenal in our case).Complete surgical resection is the treatment of choice and open surgery is the safest option when we have big tumors.Histology and Immunohistochemistry confirm the diagnosis.

Renal oncocytoma is an uncommon tumor that exhibits numerous features which are characteristic but not necessarily unique. Percutaneous biopsy is a safe method of diagnosis. However, differentiation from other tumor subtypes often requires sophisticated analysis and is not universally feasible. This is why, surgical management can be considered as a first-line treatment or after surveillance. Potential triggers for change in management are: tumor size >3 cm, stage progression, kinetics of size progression (>5 mm/y), and clinical change in patient or tumor factors. Long-term follow-up data are lacking and greater centralization should be considered to reach adequate management.

Objectives To evaluate the risk of contracting severe COVID‐19, defined as COVID‐19 specific intensive care unit (ICU) admission or death, for patients undergoing urological surgery during the epidemic. To define consequences of receiving surgery for COVID‐19 patients. Patients and Methods This is a multicenter observational cohort study. Every patient receiving a urological procedure in Paris academic urological centers during the 4 initial weeks of surgical restrictions were included. Their status was updated minimum 3 weeks after the procedure. The main outcomes were the COVID‐19 specific ICU admission and death. Statistics were mostly descriptive. The Post‐operative COVID‐19 confirmed group was compared with non‐COVID patients using Chi‐square tests for categorical and Wilcoxon test tests for continuous variables. Results During the 4‐week period, 552 patients received surgery within 8 centers. At follow‐up, 57 (10%) patients were lost. Among the 11 preoperative COVID‐19 cases, one remained in ICU, no new admission, and no death. For the non‐COVID patients, 57 (12%) developed COVID‐related symptoms; only one case (0.2%) required COVID‐19 specific ICU and 3 (0.6%) patients died of COVID‐19 after surgery. Conclusions Performing urological surgery during the COVID‐19 epidemic peak has a limited impact on ICU admissions but presents a real (0.6%) risk of specific mortality. Surgical activities should be maintained according to this risk.

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