Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks

Day, Andrew T.; Sher, David J.; Lee, Rebecca C.; Truelson, John M.; Myers, Larry L.; Sumer, Baran D.; Stankova, Lenka; Tillman, Brittny N.; Hughes, Randall; Khan, Saad A.; Gordin, Eli

doi:10.1016/j.oraloncology.2020.104684

Cited by 128 publications

(188 citation statements)

References 76 publications

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“…4 However, there is no evidence available from the current pandemic or from previous epidemics to conclude that respiratory viruses can be transmitted from patients to health professionals in the operating room via the abdominal route. 5 The European Society of Gynecological Endoscopy (ESGE) 6 and the American Association of Gynecological Laparoscopists (AAGL) 7 have issued recommendations to continue performing minimally invasive surgeries with the adoption of specific care measures, such as the reduction of surgery time; dioxide carbon (CO2) leakage through trocars; aerosol production; and the spread of droplets of blood or fluid. For these purposes, it is useful to employ a plume filtration device coupled to the trocars and avoid rapid deflation or loss of pneumoperitoneum when changing instruments or extracting surgical parts.…”

Section: Sars-cov-2 and Covid-19: Disease And Transmissionmentioning

confidence: 99%

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

Silva

Ribeiro

Brito

et al. 2020

Rev Bras Ginecol Obstet

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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.

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Section: Sars-cov-2 and Covid-19: Disease And Transmissionmentioning

confidence: 99%

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

Silva

Ribeiro

Brito

et al. 2020

Rev Bras Ginecol Obstet

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“…Some of these overlap with those suggested by Day et al in their recent guidelines. 23 Some were uncontroversial, such as a delay of surgery for most benign diagnoses. Yet even a benign diagnosis can entail critical airway obstruction or aspiration, or other acute loss of vital function for which the window of intervention could not be extended.…”

Section: Methodsmentioning

confidence: 99%

Ethical surgical triage of patients with head and neck cancer during the COVID‐19 pandemic

et al. 2020

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Background: Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended.Methods: An Otolaryngologic Triage Committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for nonsurgical options. Patients were tested twice for coronavirus before performing urgent contaminated operations. N95 masks and protective equipment were conserved when possible.Patients with low-grade cancers were advised to delay surgery, and other difficult decisions were made.Results: Hundreds of surgeries were canceled. Sixty-five cases screened over 3 weeks are tabulated. Physicians and patients expressed discomfort regarding perceived deviations from standards, but risk of COVID-19 exposure tempered these discussions. Conclusions: We describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.

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“…However, there is no available evidence from the current pandemic or from prior global influenza epidemics to conclude that respiratory viruses are transmitted via an abdominal route from patients to healthcare providers in the operating room. The risk of transmission could be increased in other types of surgery, such as head and neck surgery 4 …”

Section: General Considerationsmentioning

confidence: 99%

Practical recommendations for gynecologic surgery during the COVID‐19 pandemic

Chiofalo¹,

Baiocco²,

Mancini³

et al. 2020

Intl J Gynecology & Obste

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Surgery in suspected/confirmed COVID‐19 patients is a high‐risk venture. In infected patients, COVID‐19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID‐19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone‐sensitive pathologies should be implemented. Health risk assessment by patient history and COVID‐19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID‐19 patients or highly suspected cases, elective surgery should be postponed until full recovery.

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Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks

Cited by 128 publications

References 76 publications

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

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

Ethical surgical triage of patients with head and neck cancer during the COVID‐19 pandemic

Practical recommendations for gynecologic surgery during the COVID‐19 pandemic

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