Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?

Abstract

It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.

Access to reconstructive plastic surgery for patients undergoing bariatric surgery in the Unified Health System (SUS)

“…Unlike studies that were limited to the lockdown period, we noticed a statistically significant reduction in the total number of procedures in Brazil in all months of 2020 and 2021 [9][10][11]29 . The effect of surgical restrictions led to a decrease in supply, making access even more difficult and increasing the waiting queue for these surgeries.…”

“…Another important point is that international crises affect the Brazilian economic system, indirectly impacting SUS's capacity. During the last two years, the impact of the Sars-Cov-2 pandemic led to a financial and health system crisis in Brazil, resulting in delays and suspensions of several elective surgeries, including bariatric and reconstructive procedures [9][10][11] .…”

Acesso à cirurgia plástica reparadora para pacientes submetidos à cirurgia bariátrica no Sistema Único de Saúde (SUS)

“…Outro ponto importante é que crises internacionais afetam o sistema econômico brasileiro, impactando de forma indireta a capacidade do SUS. Durante os dois últimos anos, o impacto da pandemia Sars-CoV-2 levou à crise financeira e do sistema de saúde brasileiro, resultando em atrasos e suspensões de diversas cirurgias eletivas, incluindo procedimentos bariátricos e reparadores [9][10][11] .…”

“…Ao contrário de estudos que se limitaram ao período de lockdown, notamos que no Brasil, entre todos os meses de 2020 e 2021, houve redução estatística significativa no total de procedimentos [9][10][11]29 . O efeito das restrições cirúrgicas levou a uma diminuição da oferta, dificultando ainda mais o acesso e aumentando a fila de espera para estas cirurgias.…”

Shortcomings in the training program of medical residency during the COVID-19 pandemic in Brazil. How will they be repaired?

“…Hundreds of thousands of surgeries were postponed or canceled as a result of this pandemic, causing delay in the diagnosis and treatment of thousands of surgical/oncological cases in this period. [3][4][5][6] Despite the negative impact on the training of residents, by mid-2020, a reduction in the course of the pandemic was expected, with progressive return of clinical and surgical activities to normal in the second half of that year. In July 2020, the National Medical Residency Commission made a consultation through a specific questionnaire applied to more than 10,000 medical residents from all Brazilian states and regions.…”