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      Impact of the coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation)

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The Coronavirus (COVID-19) Pandemic represents a once in a century challenge to human healthcare with 2.4 million cases and 165,000 deaths thus far. Surgical practice has been significantly impacted with all specialties writing guidelines for how to manage during this crisis. All specialties have had to triage the urgency of their daily surgical procedures and consider non-surgical management options where possible. The Pandemic has had ramifications for ways of working, surgical techniques, open vs minimally invasive, theatre workflow, patient and staff safety, training and education. With guidelines specific to each specialty being implemented and followed, surgeons should be able to continue to provide safe and effective care to their patients during the COVID-19 pandemic. In this comprehensive and up to date review we assess changes to working practices through the lens of each surgical specialty.

          Highlights

          • •

            Minimally-invasive surgery should be avoided.

          • •

            Only emergency surgeries or those where there is a significant risk of disease progression should continue to be performed.

          • •

            Consent must be altered to include the risk of COVID-19 transmission.

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)

            Catrin Sohrabi, Zaid Alsafi, Niamh O'Neill … (2020)
            An unprecedented outbreak of pneumonia of unknown aetiology in Wuhan City, Hubei province in China emerged in December 2019. A novel coronavirus was identified as the causative agent and was subsequently termed COVID-19 by the World Health Organization (WHO). Considered a relative of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), COVID-19 is caused by a betacoronavirus named SARS-CoV-2 that affects the lower respiratory tract and manifests as pneumonia in humans. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise, with 90,870 laboratory-confirmed cases and over 3,000 deaths worldwide. In response to this global outbreak, we summarise the current state of knowledge surrounding COVID-19.
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              COVID-19 and Italy: what next?

              Andrea Remuzzi, Giuseppe Remuzzi (2020)
              Summary The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.
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                Author and article information

                Contributors
                Ahmed Al-Jabir
                Journal
                Journal ID (nlm-ta): Int J Surg
                Journal ID (iso-abbrev): Int J Surg
                Title: International Journal of Surgery (London, England)
                Publisher: IJS Publishing Group Ltd. Published by Elsevier Ltd.
                ISSN (Print): 1743-9191
                ISSN (Electronic): 1743-9159
                Publication date PMC-release: 12 May 2020
                Publication date (Electronic): 12 May 2020
                Affiliations
                [a ]GKT School of Medical Education, King's College London, United Kingdom
                [b ]Imperial College Healthcare NHS Trust, London, United Kingdom
                [c ]UCL Medical School, University College London, United Kingdom
                [d ]Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
                [e ]Stanford University, Palo Alto, United States
                [f ]Barts Health NHS Trust, London, United Kingdom
                Author notes
                [∗ ]Corresponding author. GKT School of Medical Education, Guy's Campus, King's College London, London, SE1 1UL, United Kingdom. ahmed@ 123456ijspg.com
                Article
                Publisher ID: S1743-9191(20)30385-X
                DOI: 10.1016/j.ijsu.2020.05.002
                PMC ID: 7217115
                PubMed ID: 32413502
                SO-VID: e90c530c-f5a5-49e0-b6c8-61d4d4194265
                Copyright © © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 20 April 2020
                Date accepted : 5 May 2020
                Related
                Categories
                Subject: Article

                ScienceOpen disciplines: Surgery
                Keywords: novel coronavirus,covid-19,surgery
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: novel coronavirus, covid-19, surgery

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