Delivering urgent urological surgery during the COVID‐19 pandemic in the UK: outcomes from our initial 52 patients

Paramore, Louise; Yang, Bob; Abdelmotagly, Yehia; Noureldin, Mohamed; McLean, Duncan; Rajkumar, Govindaraj; Adamson, Andrew; Emara, Amr; White, Christopher M.; Hindley, Richard G.; Nedas, Timothy

doi:10.1111/bju.15110

Cited by 6 publications

(10 citation statements)

References 4 publications

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“…A recent study from Paramore et al . [7] reported their single‐centre experience of 52 patients undergoing urological surgeries during the first 3 weeks of the British lockdown in the area of Winchester. They updated the patient status 2 weeks after surgery and reported no COVID‐19‐related symptoms.…”

Section: Discussionmentioning

confidence: 99%

Urology surgical activity and COVID‐19: risk assessment at the epidemic peak: a Parisian multicentre experience

Ingels

Bibas

Abdessater³

et al. 2020

BJU International

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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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Section: Discussionmentioning

confidence: 99%

Urology surgical activity and COVID‐19: risk assessment at the epidemic peak: a Parisian multicentre experience

Ingels

Bibas

Abdessater³

et al. 2020

BJU International

View full text Add to dashboard Cite

show abstract

“…Eight studies, all during the COVID-19 epidemics, also reported the use of telemedicine and virtual care modalities for outpatient consults and follow-up appointments. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34…”

Section: Resultsmentioning

confidence: 99%

Impact of hospital lockdown secondary to COVID-19 and past pandemics on surgical practice: A living rapid systematic review

Lee

Kirubarajan

Patro

et al. 2021

The American Journal of Surgery

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“…Indeed, a substantial number of cases are underdiagnosed. The incubation period for COVID-19 is between 5 and 14 days [12]. Therefore, virus transmission from a pre-symptomatic case can occur before symptom onset.…”

Section: Sars-cov-2mentioning

confidence: 99%

“…This must be considered as a risk during surgery. According to WHO data, asymptomatic infections in the European Union are between 1% and 3%, whereas some researchers estimate it to be~30% [12]. Among Japanese patients evacuated from Wuhan, the centre of the COVID-19 outbreak, 30.8% were asymptomatic but in close contact with SARS-CoV-2 infected people (95% CI 7.7%, 53.8%) [13] SARS-CoV-2 can be diagnosed by a combination of clinical evaluation and imaging procedures: a chest CT scan shows typical abnormalities with ground-glass opacity and bilateral patchy shadowing in >80% of cases.…”

Section: Sars-cov-2mentioning

confidence: 99%

Are urologists in trouble with SARS‐CoV‐2? Reflections and recommendations for specific interventions

2020

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Objective To assess the risk of viral infection during urological surgeries due to the possible hazards in tissue, blood, urine and aerosolised particles generated during surgery, and thus to understand the risks and make recommendations for clinical practice. Patients and Methods We reviewed the available literature on urological and other surgical procedures in patients with virus infections, such as human papillomavirus, human immunodeficiency virus and hepatitis B, and current publications on coronavirus disease 2019 (COVID‐19). Results Several possible pathways for viral transmission appear in the literature. Recently, groups have detected severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) in the urine and faeces, even after negative pharyngeal swabs. In addition, viral RNA can be detected in the blood and several tissues. During surgery, viral particles are released, aerosol‐borne and present a certain risk of transmission and infection. However, there is currently no evidence on the exact risk of infection from the agents mentioned above. It remains unclear whether or not viral particles in the urine, blood or faeces are infectious. Conclusions Whether SARS‐CoV‐2 can be transmitted by aerosols remains controversial. Irrespective of this, standard surgical masks offer inadequate protection from SARS‐CoV‐2. Full personal protective equipment, including at least filtering facepiece‐2 masks and safety goggles should be used. Aerosolised particles might remain for a long time in the operating theatre and contaminate other surfaces, e.g. floors or computer input devices. Therefore, scrupulous hygiene and disinfection of surfaces must be carried out. To prevent aerosolisation during laparoscopic interventions, the pneumoperitoneum should be evacuated with suction devices. The use of virus‐proof high‐efficiency particulate air filters is recommended. Local separation of anaesthesia/intubation and the operating theatre can reduce the danger of viral transmission. Lumbar anaesthesia should be considered especially in endourology. Based on current knowledge, COVID‐19 is not a contraindication for acute urological surgery. However, if possible, as European guideline committees recommend, non‐emergency urological interventions should be postponed until negative SARS‐CoV‐2 tests become available.

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Delivering urgent urological surgery during the COVID‐19 pandemic in the UK: outcomes from our initial 52 patients

Cited by 6 publications

References 4 publications

Urology surgical activity and COVID‐19: risk assessment at the epidemic peak: a Parisian multicentre experience

Urology surgical activity and COVID‐19: risk assessment at the epidemic peak: a Parisian multicentre experience

Impact of hospital lockdown secondary to COVID-19 and past pandemics on surgical practice: A living rapid systematic review

Are urologists in trouble with SARS‐CoV‐2? Reflections and recommendations for specific interventions

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