# ent

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  The Lancet Respiratory Medicine Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers


id: cord-018363-qr1pk78u
type: CHEMICAL
entity:
  D 1 L of polyethylene glycol based preparation n the evening before and 1 L of the same preparation on the


id: cord-035258-nff6gfik
type: DNA
entity:
  Swan Ganz catheter Pulmonary artery pseudoaneurysm etiology presentation diagnosis and treatment Pulmonary artery


id: cord-035258-nff6gfik
type: DISEASE
entity:
  impairment of vital and functional residual capacities or other surgical factors sternotomy pleural dissection


id: cord-253318-nlk8pjv2
type: WORK_OF_ART
entity:
  Fusion Rates of Lateral Lumbar Interbody Fusion Using Recombinant Human Bone Morphogenetic Protein Radiographic and CT Evaluation of Recombinant Human Bone Morphogenetic Protein 2


id: cord-253318-nlk8pjv2
type: WORK_OF_ART
entity:
  The Use of a Double Triple Barrel Technique during Minimally Invasive Multilevel Tubular Laminectomy A Technical Note Comparison of transforaminal


id: cord-034185-e0am7pa6
type: ORG
entity:
  Society for Ambulatory Anesthesia Guidelines for the Management of Postoperative Nausea and Vomiting


id: cord-034185-e0am7pa6
type: ORG
entity:
  Venturi mask World Health Organization World Federation of Societies of Anaesthesiologists WHO WFSA International Standards for a Safe Practice of Anesthesia Ketorolac


id: cord-005881-oswgjaxz
type: PROTEIN
entity:
  Neutral Position Janzing 3 L Horta 1 1 Emergency Department Viecuir medical centre The Netherlands Introduction


id: cord-005881-oswgjaxz
type: ORG
entity:
  Modified Arthroscopic Suture Fixation of a Displaced Tibial Eminence Fracture Tibial Spine Fractures in Children Fractures of the Tibial Spine in Children


id: cord-005881-oswgjaxz
type: ORG
entity:
  the Small Bone Innovations DR Perilunate and Axial Carpal Dislocations and Fracture Dislocations Evaluation of the Spanish Versió


id: cord-262556-gpnp06je
type: ORG
entity:
  the Society of American Gastrointestinal and Endoscopic Surgeons SAGES the European Association for Endoscopic Surgery EAES


id: cord-262556-gpnp06je
type: ORG
entity:
  American College of Surgeons American Society of Anesthesiologists Association of periOperative Registered Nurses Recomendaciones del Colegio


id: cord-262556-gpnp06je
type: ORG
entity:
  the American College of Surgeons ACS Recomendaciones de la Sociedad Americana de cirujanos gastrointestinales


id: cord-264631-rsmcos7j
type: ORG
entity:
  xvi Institute for Health Metrics and Evaluation American College of Surgeons State Resumption of Elective Surgery Orders Guidance


id: cord-270214-5bjow148
type: ORG
entity:
  the Chinese Center for Disease Control and Prevention Evidence for Gastrointestinal Infection of SARS


id: cord-275266-e6omvo5x
type: ORG
entity:
  the Ethical Orthopaedics for EFORT European Federation of National Associations of Orthopaedics and Traumatology


id: cord-275266-e6omvo5x
type: DISEASE
entity:
  cardiac conditions diabetes chronic lung disease chronic kidney disease immunocompromise liver disease


id: cord-005816-i54q5gsu
type: DNA
entity:
  T10 11 laminas and posterior stabilization with transpedicular screw rot system One day after the first operation T10 and


id: cord-005816-i54q5gsu
type: WORK_OF_ART
entity:
  Ambulance and Emergency Care Technicians Department Vocational School of Health Services Marmara University


id: cord-005816-i54q5gsu
type: DISEASE
entity:
  atherosclerotic heart disease diabetes mellitus hypertansion chronic obstructive pulmonary disease cerebrovascular disease


id: cord-005816-i54q5gsu
type: CHEMICAL
entity:
  C1 2 in sagittal plane SRA C1 2 and the absolute rotation angle of C2 7 ARA C2 7 Separation angles rSRA C1 2 and rARA C2 7 were


id: cord-015368-a0qz4tb9
type: PROTEIN
entity:
  VEGF bFGF IGF EGF Heparin Endothelial Cell Growth Supplement and 10 Fetal Calf Serum Expression of endothelial cell surface markers CD31 CD34 CD62e CD54


id: cord-015368-a0qz4tb9
type: PROTEIN
entity:
  NCB PH plate Zimmer Company Winterthur Switzerland In 16 cases 46 osteoporosis had been diagnosed preoperatively Radiological follow up in two planes and functional outcome is assessed clinically ROM


id: cord-015368-a0qz4tb9
type: GGP
entity:
  mellitus p ¼ 0 001 OR 1 884 peripheral artery disease p ¼ 0 003 OR 1 979 cardiogenic Shock p ¼ 0 043 OR 2 957 congestive heart failure p ¼ 0 013 OR 1 601 und emergent surgery p ¼ 0 001 OR 3 032 were predictive for development of ARF Preoperative serum creatinine


id: cord-015368-a0qz4tb9
type: GGP
entity:
  behandelbar ist sollte durch Klärung ihrer Ä tiologie eine Prävention dafür möglich werden da diese Kinder wegen ihrer kritischen Voraussetzung bereits


id: cord-015368-a0qz4tb9
type: GGP
entity:
  Hirschsprung s disease G Schimpl Background Whereas in the past various operative techniques in patients with Hirschsprung s disease HD


id: cord-015368-a0qz4tb9
type: FAC
entity:
  M Tomka A Baumann P Konstantiniuk T Ott T Cohnert Division of Vascular Surgery Department of Surgery Medical University of Graz Graz Austria Background Seventeen percent


id: cord-015368-a0qz4tb9
type: CHEMICAL
entity:
  werden Zur Behandlung stehen 2 grundsätzlich differente Vorgehensweisen zur Verfügung Im Vordergrund steht eine Resektion


id: cord-015368-a0qz4tb9
type: DISEASE
entity:
  left thorax pneumothorax lesions of the diaphragm left third of the transversal colon and neck lesions


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  zu einem eng gefassten klinischen Zustandsbild geführt haben können Dies kann entweder zu einer glatten Fehldiagnose und entsprechender Fehlbehandlung führen oder den behandelnden Arzt


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  Studie ist mit 33 3 der Gebärenden und 27 59 der erfolgreichen Schwangerschaften eine hohe Kaiserschnittrate


id: cord-015370-4jfgsic7
type: DNA
entity:
  Begleitstenose linke Nierenvene Nachuntersuchungszeit 7 Jahre bis 5 Monate komplett Schlussfolgerungen Die TAMS ist


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  Diese Kinder sind besonders gefährdet lebensbedrohliche Komplikationen wie Kathetersepsis und Leberversagen


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  Zeitraum von 57 Monaten SD 35 9 Limbergplastik als Therapie des Sinus pilonidalis Ein Erfahrungsbericht anhand von


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  ein Alterslimit Grundlagen Bis zu 30 der colorektalen Carzinome CRC treten bei Patienten älter als 70 Jahre auf Die meisten Studien


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  zur Behandlung passiver Stuhlinkontinenz dar Die Implantate werden nicht resorbiert und migrieren nicht und können


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  diese Therapieform evaluiert Weiters werden unsere Erfahrungen mit dieser OP Technik sowie Zahlen zur Zufriedenheit präsentiert Ergebnisse


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  Abteilung wurden von Jänner 2013 bis Dezember 2013 7 Transit Teilungen nach Sleeve Gastrectomie durchgeführt Ausgewertet


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  zur Defektdeckung und Muskel und Sehnentransfers zur Wiederherstellung der Handfunktion Ergebnisse In allen Fällen konnte eine weite Resektion mit freien


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  Ikterus Cholestase bei chronisch kalzifizierender Pankreatitis und entzündlichem Pseudotumor im Pankreaskopf mit rezidivierenden akuten teils


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  von Luft verhindert sowie ein Adapter zum Anschluss einer konventionellen Bülauflasche Eingeschlossen wurden Patienten


id: cord-015370-4jfgsic7
type: PROTEIN
entity:
  einem nicht diszendierten suhepatisch gelegenen Zökum Der Patient wurde daraufhin einer Ileozökalresektion mit Ileotransversostomie


id: cord-015370-4jfgsic7
type: GGP
entity:
  Schlussfolgerungen Die Untersuchung konnte zeigen dass bei präoperativer Patientenselektion und hochwertiger chirurgisch


id: cord-015370-4jfgsic7
type: GGP
entity:
  Patienten VAS 1 2 keine Rezidive Schlussfolgerungen Aus unserer Sicht eignet sich die TAPP in Single port Technik als Teaching Operation Sie ist


id: cord-015370-4jfgsic7
type: GGP
entity:
  Patientenkollektiv mit einer hohen Rezidivrate gerechnet werden Single incision laparoscopic liver resection state of the art Background The laparoscopic approach of the liver in particular resection of left lateral segments


id: cord-015370-4jfgsic7
type: GGP
entity:
  Differenzialdiagnose dieser anspruchsvollen klinischen Konstellation mit Diagnosefindung und erzielter Therapieerkenntnis hinsichtlich einer adäquaten Versorgung im klinischen Alltag zu beschreiben Fallbeschreibung Verlauf Outcome 46 jährige


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  eine Trokarhernie 1 und eine Patientin wurde wegen Adhäsionen revidiert 1 Weitere Probleme fanden sich nicht


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  ohne präoperative Manöver einen annähernd anatomischen Bauchdeckenverschluss auch nach Riesenhernien zu


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Hämoglobinwerte peri sowie postoperativ reduzierter Transfusionsbedarf und eine abgeschwächte Entzündungsreaktion bei erhaltenen Sicherheitsstan Grundlagen


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Fallotsche Tetralogie n 3 wurden rechtsventrikuläre Muskelstreifen n 15 isoliert optimal vorgedehnt mit einer modifizierten


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  eine geringgradige sowie in 2 Patienten 4 20 eine gering bis mittelgradige Aortenklappeninsuffizienz


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  werden kann Die erstmalige konzeptchirurgische Anwendung der DO im Mitttelgesicht im Rahmen komplexer


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  sich beim laparoskopischen Vorgehen signifikant niedriger p 0 001 insbesondere in der Altersklasse zwischen 60


id: cord-015370-4jfgsic7
type: DISEASE
entity:
  anschaulich dargestellt Die von uns erhobenen Ergebnisse der letzten acht Jahre werden anhand von über


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Patienten 70 Jahre n 38 Patienten 80 Jahre n 23 Patienten 90 Jahre n 5 Die 3 Monatsmortalität betrug


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  eine optimale Behandlung der Wunde selbst ohne Traumatisierung der Kinder durch schmerzhafte Verbandwechsel gewährleisten Bei 8 Kindern im Alter von 2 4 6 8 9


id: cord-015370-4jfgsic7
type: DISEASE
entity:
  System wurde von den Kindern gut und ohne wesentliche Erfordernis zur Analgetikagabe toleriert die Behandlung konnte


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Adipositaschirurgie Adipositas Metabolische Chirurgie I Langzeitergebnisse nach malabsorptiven bariatrischen Eingriffen Grundlagen


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Patienten mit einem hohen Erkrankungsalter eine Tall Cell Variante in Betracht gezogen werden um durch eine aggressive Therapie eine lokale Kontrolle mit günstigerer Prognose zu erreichen


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Patienten n 2 12 Monte Beobachtungszeitraum sind ohne Tumorprogression bzw Rezidiv 2 4 aufgrund einer


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  gefäßchirurgischen Managements eines monströsen A hepatica Aneurysmas direkt im Leberhilus unter Reflexion einschlägiger


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  eines Lokalrezidivs sowie einer Pleuracarzinose geäußert der mittels Minithorakotomie histologisch gesichert wurde Die Patientin


id: cord-015370-4jfgsic7
type: CHEMICAL
entity:
  Patienten mit peripherer arterieller Verschlusskrankheit pAVK Stadium IIb auch im gefäßchirurgischen


id: cord-276676-lgt0rzob
type: PROTEIN
entity:
  cord 276676 lgt0rzob authors Moka Eleni Paladini Antonella Rekatsina Martina Urits Ivan Viswanath Omar Kaye Alan D Yeam


id: cord-276676-lgt0rzob
type: ORG
entity:
  the Canadian Society of Cardiac Surgeons American College of Surgeons COVID 19 Guidelines for Triage of Cardiac


id: cord-290771-18dj37dj
type: CHEMICAL
entity:
  Matthew H G Weinberg Jeffrey S Lai Stephen Y Antonoff Mara B Bird Justin E Shafer Aaron Davis John W Adelman David M Moon Bryan Reece Gregory Prabhu Sujit S DeSnyder Sarah M Skibber John M Mehran Reza Schmeler Kathleen Roland Christina L Tran


id: cord-283215-dgysimh5
type: ORG
entity:
  China American College of Surgeons COVID 19 Guidelines for Triage of Thoracic Cancer Patients American College of Surgeons Committee


id: cord-283215-dgysimh5
type: ORG
entity:
  National Institute for Health and Care Excellence NICE Preliminary Recommendations for Surgical Practice of Neurosurgery Department


id: cord-278609-zxdd06ur
type: DISEASE
entity:
  cancers of the head and neck but lacks details on reconstruction 13 However head and neck reconstruction


id: cord-277803-7p1qu2rf
type: DISEASE
entity:
  acute respiratory syndrome coronavirus 2 SARS CoV 2 Upper gastrointestinal endoscopy another aerosol


id: cord-295216-eff02z0i
type: ORG
entity:
  the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology Management of


id: cord-287376-wxldnlih
type: PRODUCT
entity:
  Chirurgische Rauchgase Gefährdungen und Schutzmaßnahmen Effect of Robotic Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients


id: cord-294849-qgr0e0gt
type: ORG
entity:
  the University of Michigan Institute for Healthcare Policy and Innovation Clinician Scholars Program


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  mit einem Memory Ring armiert wurde und alle 3 Hernienkompartimente der Leiste abdeckt Basierend auf 909 durch


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Hernien ohne Peritonealbeteiligung Schlussfolgerungen Aufgrund dieser Ergebnisse sollte bei klinisch diagnostizierten Hernien


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Experimentelle Behandlung ist nach dem Arzneimittel und Medizinprodukte Gesetz nur im Rahmen klinischer Prüfungen zulässig Schlussfolgerungen Alle angeführten Modalitäten sind unter bestimmten Rahmenbedingungen vor


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Patienten kam ausschließlich ein lokales Antiseptikum zur Anwendung Das Patientengut hatte eines gemeinsam


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  wurde Sehnenscheidengewebe von 10 Patient Innen die sich einer Tenolyse unterzogen Sehnenscheidengewebe von 10


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Gefrierschnitten wurden mit Hilfe von monoklonalen Antikörpern gegen T Lymphozyten und Makrophagen immunhistochemische Untersuchungen


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Im Vergleich zur Kontrollgruppe zeigte sich eine statistisch signifikante Erhöhung von T Lymphozyten im Patientengewebe Auch


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  einem Patienten fand sich neben einer ausgeprägten streck und beugeseitigen Infektlokalisation auch ein Handgelenksempyem mit


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Erfahrungen mit dieser Methode werden dargestellt Methodik In einer single center Studie wurden Patienten


id: cord-015369-72cjogxz
type: DNA
entity:
  Extremität Trotz eines mitunter sehr aufwändigen operativen Verfahrens konnte die Zeit bis zur kompletten Abheilung deutlich


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  nicht genügend ergaben sich durchnschnittliche Werte von 1 2 Trokarplatzierung 1 2 Nadelplatzierung 1 Führungsdrahteinlage 1 Faszienverschluss 1 2 Lernkurve Schlussfolgerungen Der neue TIC Faszienverschlusstrokar ist als leicht erlernbares


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  diesen Patienten 22 Abszessdrainagen 23 Fistelspaltungen 15 Fistelexzisionen sowie 10 Exzisionen mit Mucosa Flap durchgeführt Bei 13 Patienten musste wegen


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Nervendurchtrennung konnte bisher trotz Anwendung modernster Techniken keine zufriedenstellende funktionelle Regeneration erzielt werden Die verzögerte Nervenregeneration und


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  von Kinking mit Obstruktion und Drucknekrosen des Roux Schenkels verstarben In der anterogastrischen Gruppe überlebte ein Tier mit Abheilung des Leaks jedoch mit Stentmigration nach distal Die übrigen 3 Tiere verstarben zwischen dem 4 und 6 postoperativen Tag


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  werden kann Die ersten Ergebnisse der durchgeführten Segmentdistraktionen bei Patienten mit kompletten


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Behandlung bei einem reparativen Riesenzellgranulom gegenübergestellt und diskutiert Ein Rezidiv bei dieser Patientin


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  partieller 4 11 und kompletter 7 11 Remission während Thrombozyten 150 000 ml überwiegend zu einer kompletten Remission 35 42 führten Schlussfolgerungen Die laparoskopische Splenektomie ist ein sicheres Verfahren bei selektionierten Patienten und gilt als chirurgisches Standardverfahren bei der therapierefraktären ITP


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  von 4 Wochen Die 39 offenen Wundbehandlungen führten nach einer Behandlungsdauer zwischen 8 1 2 und 12


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  von 204 AE 123 Minuten durchgefü hrt werden Die Größe der implantierten Netze lag zwischen 16 Â 16 und 20 Â 19


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  bislang keine nennenswerten Komplikationen Schlussfolgerungen Obwohl Langzeitergebnisse noch ausstehen ist diese Methode der Hämorridenoperationen als komplikationsarm sphinkterschonend und somit sehr empfehlenswert zu bewerten Sie zeichnet sich zudem aus durch eine hohe PatientInnenzufriedenheit


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Dissektionen unter Verwendung einer Hybridprothese Methodik Zwischen 08 05 und 12 08 wurde 6 Patienten 44 5 AE 15 5 Jahre 5 männlich 1 weiblich mit Aortendissektion Typ A 3 akut 3 chronisch die E Vita Open Endoluminal Stentgraftprothese im Kreislaufstillstand


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  einer hochauflösenden Videoendoskopie unter Einbeziehung einer virtuellen oder realen Chromoendoskopie


id: cord-015369-72cjogxz
type: DNA
entity:
  Risikoscore evaluiert Zahlreiche operative laborchemische und klinische Daten wurden anlaysiert Ergebnisse Die beiden randomisierten Gruppen waren bis auf das Vorliegen von Diabetes der


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  wurde eine HER 2 neu FISH Analyse bei allen 150 Karzinompräparaten angewendet Ergebnisse LMVD korrelierte signifikant mit LVI p 0 005 und


id: cord-015369-72cjogxz
type: DNA
entity:
  Y I Havrysh 1 Y I Shavarow 1 M P Pavlovskyy 2 A T Chykaylo 1 1 Lviv Regional Hospital Lviv Ukraine 2 Lviv Medical University Lviv Ukraine


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  einem Tübinger Boxtrainer mit beziehungsweise ohne 15 Minütigen präoperativem Aufwärmen an einem Laparoskopie Simulator LapSim Surgical Science durch


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  zur Vermeidung eines Lokalrezidivs aufgezeigt Methodik Ein 36 jähriger Patient stellte sich mit einem


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  normofrequenter Sinusrhythmus ein ein postoperatives 24 stunden Holter zeigte durchgehenden Sinusrhythmus mit einer Frequenz von 54 84 min Bei den Kontrollen nach 3 und 6


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Lymphknotenschwellung mit B Symptomatik Splenomegalie und Hepatomegalie Die Diagnosesicherung erfolgt durch Biopsie


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  Einleitung einer Therapie mit einem monoklonalen chimären Antikörper Rituximab Mabthera wurden eine signifikante Besserung der klinischen Symptomatik sowie eine deutliche Befundregredienz erreicht


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  einer perforierten Sigmadivertikulitis mit stercoraler Peritonitis notfalllaparotomiert wobei eine Stomasituation nach Hartmann angelegt werden musste sowie eine Dünndarmteilresektion mit einem endständigen


id: cord-015369-72cjogxz
type: PROTEIN
entity:
  V A C System und anschließendem sekundärem Wundverschluss behandelt wurde Schlussfolgerungen Die endoskopische Entnahme der VSM ist


id: cord-015369-72cjogxz
type: GGP
entity:
  Mammakarzinomes ist von zentraler Bedeutung Trotz der vielfachen Möglichkeit einer brusterhaltenden Therapie zwingen spezielle Indikationen auch heutzutage noch zu einer kompletten Entfernung


id: cord-015369-72cjogxz
type: GGP
entity:
  Radikalität eines chirurgischen Debridements eine Infektsanierung erzielt werden Schlussfolgerungen Das V A C


id: cord-015369-72cjogxz
type: GGP
entity:
  Abfall von CA 19 9 p ¼ 0 025 Die VEGF Spiegel korrelierten positiv mit der Bevacizumab Therapie und stiegen bereits mit der ersten Behandlung signifikant an p ¼ 0 004 Background Endoscopic


id: cord-015369-72cjogxz
type: GGP
entity:
  Ringbänder im Rahmen eines zweizeitigen Verfahrens unter intermittiernder Verwendung eines Silastikstabes Wir gehen


id: cord-015369-72cjogxz
type: ORG
entity:
  University Clinic for Surgery Graz Austria 2 Institute for Pathology Graz Austria Background Isolation


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  allen Patienten auf Bei 2 Patienten wurde wegen eines Rezidivs eine neuerliche RFT mit liver packing notwendig 5 Patienten wurden ohne Packing


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  ausoperierten Dialysepatienten Ergebnisse Der Erhalt des gefährdeten Beines gelang bei 6 Patienten 85 bei 5 konnten durch


id: cord-015369-72cjogxz
type: DISEASE
entity:
  Danach wurde der Transplantatstiel mit der zur Arteria und Vena temporalis superficialis anastomosiert


id: cord-015369-72cjogxz
type: DISEASE
entity:
  Differenzierungspotential darunter leidet Im Rahmen der Bestrahlung werden neben dem eigentlichen Zielvolumen entartete Krebszellen auch alle gesunden Zellen samt


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  einem Fall wurde präoperativ eine Mukosektomie einer ektopen Magenschleimhaut im Oesophagus durchgeführt Ergebnisse Aufgrund der Indikationsstellung mit Verzicht auf eine Lymphadenektomie entlang


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  beim synchron metastasierten Rektumkarzinom zunehmend eine Ä nderung der Behandlungsstrategie diskutiert Die Vorstellung dass eine systemische Erkrankung eine systemische Behandlung benötigt


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  des Ö sophagus wurden 2007 aus 3 Arbeitsgruppen 5 Jahres Ü berlebensdaten publiziert hier zeigte sich


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  Patienten 10 4 verstorben Die präoperativen Risikofaktoren in Bezug auf die Mortalität wie renale Insuffizienz 38 1 vs 39 3 p ¼ 0


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  Patienten wurden in zwei Gruppen stratifiziert Gruppe A wurde unmittelbar nach der Herzoperation mit der


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  eine vollständige Wiederherstellung der Beweglichkeit nach 2 Tagen und 2 Wochen Die Stimulationsdauer des


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  Patienten wurde im Rahmen einer Koloskopie wegen persistierender Abdominalbeschwerden eine Pancolitis ulcerosa


id: cord-015369-72cjogxz
type: DISEASE
entity:
  bildlich dargestellt werden Ergebnisse Bei allen 6 Probanden konnte bewiesen werden das immer der mechanisch


id: cord-015369-72cjogxz
type: CHEMICAL
entity:
  sich bis zur Entlassung ins Rehabilitationszentrum Bei Langliegern werden Antibiotika nur nach vorliegendem Antibiogramm verabreicht


id: cord-303054-s1clwunc
type: CHEBI
entity:
  anaesthetics lidocaine levobupivacaine bupivacaine prilocaine mepivacaine ropivacaine ketamine midazolam sufentanil oxycodone


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type: ORG
entity:
  Executive Board Operating Theatre Committee Healthcare Infection Control Practices Advisory Committee


id: cord-303054-s1clwunc
type: ORG
entity:
  Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers


id: cord-317468-pnxni1x5
type: ORG
entity:
  Cost Effectiveness of Telemedicine in Remote Orthopedic Consultations Randomized Controlled Trial Surgery


id: cord-317468-pnxni1x5
type: ORG
entity:
  the International Consensus Group ICM Evidence of Benefit of Telerehabitation After Orthopedic Surgery A Systematic Review Cytokine


id: cord-332960-h0be6pr0
type: ORG
entity:
  SAGES Society of American Gastrointestinal and Endoscopic Surgeons Recommendations Surgical Response


id: cord-323314-y3k9dntf
type: ORG
entity:
  the Difficult Airway Society the Association of Anaesthetists the Intensive Care Society the Faculty of Intensive Care Medicine


id: cord-327314-8vz9x8f1
type: GGP
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  Clin Anesth DOI 10 1016 j jclinane 2020 109871 sha 9043a71a530355e23f5c5acfe0710c5b9179b110 doc_id 327314 cord_uid 8vz9x8f1 nan


id: cord-327314-8vz9x8f1
type: GGP
entity:
  lactate Plt platelet POD Table 1 Baseline demographics comorbidities and types of surgery Laparoscopic radical nephrectomy 2 9 1 Laparoscopic radical prostatectomy 2 9 1 Laparoscopic radical cystectomy 2 9 1


id: cord-349740-xed4aybr
type: ORG
entity:
  National Health Commission of the People s Republic of China State Administration of Traditional Chinese Medicine Prevention


id: cord-010980-sizuef1v
type: PROTEIN
entity:
  ROTEM parameters activated protein C aPC thrombomodulin endothelial protein C receptor thrombin antithrombin complex TAT plasminogen activator inhibitor 1 PAI 1


id: cord-010980-sizuef1v
type: DNA
entity:
  Kirov Military Medical Academy War Surgery Department The Combat Trauma Registry includes 5581 Russian wounded


id: cord-010980-sizuef1v
type: GGP
entity:
  Psychopathy b 0 177 p 0 034 Conclusions This study provides evidence for future knife carrying prevention interventions such as talks in schools or social media videos to focus more on how to increase self esteem stimulate empathy for and better


id: cord-010980-sizuef1v
type: GGP
entity:
  aPC thrombomodulin endothelial protein C receptor thrombin antithrombin complex TAT plasminogen activator inhibitor 1 PAI 1


id: cord-010980-sizuef1v
type: GGP
entity:
  Processes A Case Report Case history Clinical findings and Diagnosis 17 year old male low speed motorcycle crash with subsequent polytrauma He presented with right shoulder pain swelling and pain to the touch Articular CT revealed a type I fracture of the coracoid base type III acromion fracture and scapular body


id: cord-010980-sizuef1v
type: ORG
entity:
  Oslo University Hospital Department of Traumatology Oslo Norway 3 Oslo University Hospital Trauma Registry


id: cord-010980-sizuef1v
type: LAW
entity:
  Exploration of the middle finger reviled heavy contamination and comminution of the phalanx with injury to one


id: cord-010980-sizuef1v
type: ORG
entity:
  Osaka University Graduate School of Medicine Department of Traumatology and Acute Critical Medicine SUITA Japan


id: cord-010980-sizuef1v
type: ORG
entity:
  Osaka University Graduate School of Medicine Environmental and Population Science SUITA Japan Introduction


id: cord-010980-sizuef1v
type: ORG
entity:
  Medical University Graz Graz Austria 4 AUVA Unfallkrankenhaus Graz Austria 5 Medical University Graz Orthopaedics


id: cord-353004-ocnp758o
type: CELL_LINE
entity:
  China COVID 19 coronavirus recommended personal protective equipment for the orthopaedic and trauma surgeon Sterile field contamination from powered air purifying respirators PAPRs


id: cord-353004-ocnp758o
type: GGP
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  Saf Surg DOI 10 1186 s13037 020 00254 6 sha 96f892f49c5628a06ab6bafd34ddd0a4fd114100 doc_id 353004 cord_uid ocnp758o BACKGROUND The COVID 19


id: cord-006854-o2e5na78
type: GGP
entity:
  n 13 11 9 p 0 05 and organ space infection n 0 0 0 vs n 2 1 8 p 0 05 respectively Conclusions A preoperative antimicrobial protocol using cefazolin metronidazole


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  Hrishikesh Salgaonkar Raquel Maia Lynette Loo Wee Boon Tan Sujith Wijerathne Davide Lomanto National University Hospital Singapore Laparoscopic repair of groin hernias


id: cord-006854-o2e5na78
type: ORG
entity:
  Minimally Invasive Management of Diaphragmatic Hernias After Esophagectomy A Case Report Introduction Esophagectomy


id: cord-006854-o2e5na78
type: ORG
entity:
  Masafumi Ohira Department of Gastroenterological Surgery Hokkaido University Graduate School of Medicine Background


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  S359 Augmenting Spatial Awareness in Laparoscopic Surgery by Immersive Holographic Mixed Reality Navigation


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  Ibrahim A Salama Professor Department of Hepatobiliary Surgery National Liver Institute Menoufia University Abstract Background Iatrogenic


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  S359 Taking the Training Wheels Off Transitioning from Robotic Assisted to Total Laparoscopic Whipple Introduction


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  The Effect of Peri operative Antibiotic Drug Class on the Resolution Rate of Hypertension After Roux


id: cord-006854-o2e5na78
type: ORG
entity:
  the American College of Surgeons the Academic Association of Surgery and the Society of American Gastrointestinal and Endoscopic Surgeons


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  Yoshiyuki Usui MD PhD Ichiro Akiyama MD PhD Hironori Kunisue MD PhD Hideaki Mori MD PhD Tetsuya Ota MD PhD Okayama Medical Center Background and Methods


id: cord-006854-o2e5na78
type: ORG
entity:
  Laparoscopic Antireflux Surgery for Gastroesophageal Reflux Disease Effectiveness and Economic Benefits Kyung Won Seo


id: cord-006854-o2e5na78
type: WORK_OF_ART
entity:
  The Essential Role of the Transcystic Duct Tube C Tube During Laparoscopic Common Bile Duct Exploration LCBDE Towakai Hospital Introduction Laparoscopic


id: cord-006854-o2e5na78
type: ORG
entity:
  Priscila R Armijo MD 1 Dmitry Oleynikov MD 1 Sages Robotic Task Force 2 1 University of Nebraska Medical Center 2


id: cord-006849-vgjz74ts
type: DNA
entity:
  biliary tree Endoscopia Digestiva Chirurgica Policlinico Universitario A Gemelli ROME Italy 2 IHU STRASBOURG France 3 Camma Group ICube University


id: cord-006849-vgjz74ts
type: PROTEIN
entity:
  LSG R Bademci 1 R Vilallonga 2 P Alberti 2 R Renato 2 C Yuhamy 2 S S Cordero 2 L Posadas 2 1 General surgery Istanbul medipol


id: cord-006849-vgjz74ts
type: DNA
entity:
  target line Esofagogástrica Cirugía General y Ap Digestivo Hospital Regional Universitario de Málaga MALAGA Spain 2 Hepatobiliopancreática Hospital Regional Universitario de Málaga MALAGA Spain Introduction Marginal ulcer


id: cord-006849-vgjz74ts
type: PROTEIN
entity:
  LLR V Drakopoulos S Voulgaris I Iliadis K Botsakis P Trakosari V Vougas 1st Department of Surgery and Transplantation Unit District General Hospital of Athens Evangelismos ATHENS Greece Introduction Laparoscopic surgery


id: cord-006849-vgjz74ts
type: PROTEIN
entity:
  S2 153 6 62 5 min vs 179 3 55 2 min p 0 037 and 59 7 45 7 ml vs 100 0 74 0 ml p 0 027 respectively Specimen quality and early postoperative complications


id: cord-006849-vgjz74ts
type: GGP
entity:
  HSA r 0 5402 p 0 0064 however strength of association was weak r 2 0 2918 and CT consistently overestimated the size of hiatal defect intra operatively mean of differences 404 mm 2 p 0 0016 Crural tension was positively correlated with age r 0 3321 p 0 0044 hiatal height r 0 6023 p 0 0001 hiatal width r 0 766 p 0 0001 and HSA r 0 7753 p 0 0001 Crural tension


id: cord-006849-vgjz74ts
type: GGP
entity:
  mammary line 3 triangle 5 mm trocars after pneumo under vision Section with Ligasure of gastroesplenic ligament with short vessels and phrenic splenic ligament Identification and preservation of pancreatic tail Section of splenic vessels


id: cord-006849-vgjz74ts
type: CL
entity:
  fibroblastic mesenchymal neoplasm tipically arising from the pleura less frequently from other anatomic sites


id: cord-006849-vgjz74ts
type: GGP
entity:
  MEN I familial hyperparathyroidism MEN2A hyperparathyroidism jaw tumor syndrome parathyroidectomy minimally invasive for the time period up to and including December 2018 Full publications including clinical trials randomized or not retrospective studies case series case reports that provided relevant data met inclusion criteria


id: cord-006849-vgjz74ts
type: ORG
entity:
  Medical Faculty University of Tetove TETOVE Macedonia 3 Anestesiology Medical Faculty University of Tetove TETOVE Macedonia 4


id: cord-006849-vgjz74ts
type: WORK_OF_ART
entity:
  CAN WE PREDICT THE SUCCESS OF THE LAPAROSCOPIC APPROACH IN THE ADHESIVE SMALL BOWEL OBSTRUCTION C Tellez Marques E Sebastian Valverde


id: cord-006849-vgjz74ts
type: ORG
entity:
  Gastroenterological Surgery Saitama Medical University International Medical Center HIDAKA SHI SAITAMA Japan


id: cord-006849-vgjz74ts
type: EVENT
entity:
  A NOVEL ABDOMINAL NEGATIVE PRESSURE LAVAGE DRAINAGE SYSTEM FOR ANASTOMOTIC LEAKAGE AFTER R0 RESECTION


id: cord-006849-vgjz74ts
type: DISEASE
entity:
  cartilage 16001 carotid artery 81567 muscle 5149 carotid vein 7148 portal vein 22973 biliary tract 73940 gallbladder 1874 hepatic artery 16712 pancreas 2412 duodenum 34313 abdominal


id: cord-006849-vgjz74ts
type: DISEASE
entity:
  inferior mesenteric vein division Left colonic and splenic flexure mobilization Pancreas identification Rectal dissection


id: cord-006849-vgjz74ts
type: DISEASE
entity:
  postoperative complications gastrogastric anastomosis leak 1 Introduction Laparoscopic sleeve gastrectomy is the most


# bib

id: cord-005816-i54q5gsu
title: 10(th) European Congress of Trauma and Emergency Surgery: May 13–17, 2009 Antalya, Turkey
author: nan
date: 2009-08-06
txt: ./txt/cord-005816-i54q5gsu.txt
cache: ./cache/cord-005816-i54q5gsu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095784/
doi: 10.1007/s00068-009-8001-z
abstract: nan
summary:
  Several factors such as the initial lack of symptoms, a low diagnostic sensitivity of the CT (34% false negatives), and the nonoperative management of solid organ injuries, have contributed to a delayed diagnosis in one of every five patients in our series, but this has not led to a significant increase in septic complications in this group. Method: The demographic features, the treatments, the intensity of the illness and mortality rate of the 155 patients in Afyon Kocatepe University General Surgery clinic between the years 2006 Background: Enterocutaneous fistula continues to be a serious surgical problem. Introduction: In our previous study, we examined the treatment results of burn patients older than 45 years, and found a significant increase in mortality with increasing age groups. Methods: Data on emergency surgical cases and admissions to the surgical service over a 3-month period were collected and analyzed; this included patient demographics, referral sources, diagnosis, operation, and length of stay (LOS Conclusion: Emergency workload represents a significant part of the work for the general surgeons.


id: cord-005881-oswgjaxz
author: nan
date: 2010
txt: ./txt/cord-005881-oswgjaxz.txt
cache: ./cache/cord-005881-oswgjaxz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095891/
doi: 10.1007/s00068-010-8888-z
abstract: nan
summary:
  Prospective case series with historical control group.(Level III) Results: Preliminary data indicate: *a shorter time on ventilator than anticipated (based on comparisson to historical data) * a shorter time on ICU * less pneumoniae * no intra-operative complications * good healing results of the rib fractures * no implant failures * acceptable pain scores * good overal satisfaction * acceptable cosmetic results Conclusion: Internal fixation of rib fractures (flair chest or multiple sequential fractures with pulmonary function compromise) results in a earlier recuperation of pulmonary function with shortened ICU stay. (Regional Association Sanitary Emergencies) Material and Methods: The ARES, whose members are about 600, all over the nation, is configured as an extraordinary health resource, activated by the National Civil Defence operations centre, in according with the Regional centre of Marche, in disater situations Results: The main objectives of ARES are training and organization of medical staff and structures and its growth crosses several missions including: AE Earthquake in Molise, 2002 Introduction: Cephalomedullary nails rely on a large lag screw that provides fixation into the femoral head.

title:
  Abstracts: 11(th) European Congress of Trauma and Emergency Surgery May 15–18, 2010 Brussels, Belgium


id: cord-006563-qmigctkp
title: The abstracts of the 26th congress of ESCTAIC, Timisoara, Romania, September 22–24 2016
author: nan
date: 2017-03-07
txt: ./txt/cord-006563-qmigctkp.txt
cache: ./cache/cord-006563-qmigctkp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102034/
doi: 10.1007/s10877-017-9991-4
abstract: nan
summary:
  This is the reason why in the last decades a lot of clinical studies have been performed with the aim of reducing the magnitude of the postoperative pain, all of them directed to those factors which might influence the pain after surgery, such as: presence of preoperative chronic pain, anesthesia technique, or the need for an acute pain service. The list of proposals to be taken into consideration includes: a careful psychological evaluation and preparation of the surgical patient, a good preoperative sedation and even the use of antidepressants before surgery in specific cases. Regional anesthesia and ambulatory surgery: the role of continuous infusion devices in postoperative pain management in pediatrics Ralph J Beltran Department of Anesthesiology and Pain Medicine, Nationwide Children''s Hospital, Columbus, Columbus, OH, USA Continuous infusions of local anesthetic delivered via peripheral nerve block catheters (PNB) for postoperative pain management in adult patients has become more prevalent.


id: cord-006849-vgjz74ts
author: nan
date: 2019-09-13
txt: ./txt/cord-006849-vgjz74ts.txt
cache: ./cache/cord-006849-vgjz74ts.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103177/
doi: 10.1007/s00464-019-07109-x
abstract: nan
summary:
  Methods: We are performing this procedures within a prospective randomized trial that is design to compare the long term results of LRYGB-B versus the standard laparoscopic Roux-en-Y gastric bypass.The video shows our technique in a case of a 46 years old female with a BMI of 46 Kg/m2. Material and methods: We present a video of the surgical intervention of a 32-year-old patient, with functional dyspepsia, with a casual diagnosis of a pseudocystic mass of the right colon after performing a CT scan: giant diverticulum of the hepatic colon angle with fecaloid content inside it under tension The patient goes to the emergency room for acute abdominal pain, pending colonoscopy, antibiotic treatment is established, and a laparoscopic approach is decided upon after the patient''s evolution. Method: We present the case of a 65-year-old patient with surgical antecedent of laparoscopic low anterior resection due to rectal cancer, presenting in postoperative period an anastomosis leakage with severe peritonitis was identified and a laparotomy with end colostomy was performed.

title:
  27th International Congress of the European Association for Endoscopic Surgery (EAES) Sevilla, Spain, 12–15 June 2019


id: cord-006854-o2e5na78
author: nan
date: 2018-04-20
txt: ./txt/cord-006854-o2e5na78.txt
cache: ./cache/cord-006854-o2e5na78.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103183/
doi: 10.1007/s00464-018-6121-4
abstract: nan
summary:
  Totally Laparoscopic ALPPS Combined with the Microwave Ablation for a Patient with a Huge HCC Hua Zhang; Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University Introduction: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting hepatic tumors that were previously considered unresectable due to the insufficient future liver remnant (FLR) which may result in postoperative liver failure (PLF). Not only does this case show that a large epiphrenic diverticulm can be successfully resected via the trans-abdominal laparoscopic approach, this case makes the argument that patients undergoing any minimally-invasive epiphrenic diverticulectomy and myotomy, with or without fundoplication, may be successfully managed with early post-operative contrast studies and dietary advancement, thus decreasing their length of hospitalization and overall cost of treatment. Introduction: There are reports of increased operative duration, blood loss and postoperative morbidity, caused by difficulties in obtaining good visualization and in controlling bleeding when laparoscopic resection is performed in obese patients with colon cancer.

title:
  Scientific Session of the 16th World Congress of Endoscopic Surgery, Jointly Hosted by Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) & Canadian Association of General Surgeons (CAGS), Seattle, Washington, USA, 11–14 April 2018: Poster Abstracts


id: cord-007547-gdsoc93j
title: Counting the cost of cancelled surgery: a system wide approach is needed
author: Gillies, M.A.
date: 2018-09-07
txt: ./txt/cord-007547-gdsoc93j.txt
cache: ./cache/cord-007547-gdsoc93j.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118877/
doi: 10.1016/j.bja.2018.08.002
abstract: nan
summary:
  A recent prospective epidemiological study over a 1 week period in NHS hospitals suggested a cancellation rate of between 10% and 14% and that only one-third of these were because of clinical reasons. In this issue of the British Journal of Anaesthesia, Wong and colleagues 3 present a prospective observational study exploring the reasons for cancellation on the day of surgery in 245 NHS hospitals across the UK. Reducing or even stopping elective operating completely in winter months is unlikely to be a long-term solution to this problem, as many hospitals report capacity issues beyond the traditional winter months and the postponed surgery must be accommodated at another time in the year. 12 Enhanced care wards have been suggested as an alternative to critical care for patients undergoing major surgery, however, this study did not suggest that their presence reduced the rate of cancellation.


id: cord-010980-sizuef1v
title: ECTES Abstracts 2020
author: nan
date: 2020-05-11
txt: ./txt/cord-010980-sizuef1v.txt
cache: ./cache/cord-010980-sizuef1v.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223217/
doi: 10.1007/s00068-020-01343-y
abstract: nan
summary:
  We hypothesized that presentation to a PTC would yield increased mortality when subspecialty intervention was required and that this would be most pronounced at night when in-house attending coverage is absent at all state PTCs. Materials and methods: A review of the Pennsylvania Trauma Outcome Study (PTOS) database was performed to capture patients aged 12-18 who underwent any non-orthopedic trauma surgery. Traumatic subaxial cervical fractures: functional prognostic factors and survival analysis Introduction: The main goal of this study is to identify the risk factors for poor functional outcomes and to analyze the overall survival (OS) and complications rate in patients with traumatic cervical spinal cord injury (SCI) and subaxial cervical fracture (SACF) treated with open surgical fixation. After applying a multiple imputation on all the study variables, a logistic regression generalized estimating equation after adjustment for age, sex, mechanism of trauma, and the injury severity score as covariates and hospitals as a cluster assessed an association between quartile of patient volume in intensive care unit and hospital mortality.


id: cord-011234-awbubjy4
author: Acevedo, Edwin
date: 2019-06-17
txt: ./txt/cord-011234-awbubjy4.txt
cache: ./cache/cord-011234-awbubjy4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223848/
doi: 10.1007/s00464-019-06917-5
summary:
  This study represents the largest case-controlled retrospective review of the MBSAQIP PUF database comparing perioperative outcomes in laparoscopic-and robotic-assisted revisional/ conversional bariatric surgery. Our case-control matched analysis of 2288 revisional bariatric cases revealed longer operative duration and hospital length of stay, and higher rates of ICU admission, aggregate leak and bleeding complications in the robotic-assisted bariatric surgery compared to conventional laparoscopy. Taking into consideration the above outlined study limitations, the findings of this case-control matched analysis comparing these two surgical approaches for revision/conversion metabolic and bariatric surgery show that using the robotic platform is overall safe, but is associated with longer operative times and a higher rate of some perioperative outcome measures.

title:
  Outcomes in conventional laparoscopic versus robotic-assisted revisional bariatric surgery: a retrospective, case–controlled study of the MBSAQIP database

abstract:
  INTRODUCTION: Revisional bariatric surgery is being increasingly performed and is associated with higher operative risks. Optimal techniques to minimize complications remain controversial. Here, we report a retrospective review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant User Files (PUF) database, comparing outcomes between revision RBS and LBS. METHODS: The 2015 and 2016 MBSAQIP PUF database was retrospectively reviewed. Revision cases were identified using the Revision/Conversion Flag. Selected cases were further stratified by surgical approach. Subgroup analysis of sleeve gastrectomy and gastric bypass cases was performed. Case–controlled matching (1:1) was performed of the RBS and LBS cohorts, including gastric bypass and sleeve gastrectomy cohorts separately. Cases and controls were match by demographics, ASA classification, and preoperative comorbidities. RESULTS: 26,404 revision cases were identified (93.3% LBS, 6.7% RBS). 85.6% were female and 67% white. Mean age and BMI were 48 years and 40.9 kg/m(2). 1144 matched RBS and LBS cases were identified. RBS was associated with longer operative duration (p < 0.0001), LOS (p = 0.0002) and a higher rate of ICU admissions (1.3% vs 0.5%, p = 0.05). Aggregate bleeding and leak rates were higher in the RBS cohort. In both gastric bypass and sleeve gastrectomy cohorts, the robotic-assisted surgery remain associated with longer operative duration (p < 0.0001). In gastric bypass, rates of aggregate leak and bleeding were higher with robotic surgery, while transfusion was higher with laparoscopy. For sleeve gastrectomy cases, reoperation, readmission, intervention, sepsis, organ space SSI, and transfusion were higher with robotic surgery. CONCLUSION: In this matched cohort analysis of revision bariatric surgery, both approaches were overall safe. RBS was associated with longer operative duration and higher rates of some complications. Complications were higher in the robotic sleeve cohort. Robotic is likely less cost-effective with no clear patient safety benefit, particularly for sleeve gastrectomy cases.


id: cord-015368-a0qz4tb9
title: 48th Annual Meeting of the Austrian Society of Surgery, Graz, June 7–9, 2007
author: nan
date: 2007
txt: ./txt/cord-015368-a0qz4tb9.txt
cache: ./cache/cord-015368-a0qz4tb9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103188/
doi: 10.1007/s10353-007-0330-8
abstract: nan
summary:
  Surgical treatment and evaluation, complications, short and long term patency of our patients were compared to interventional techniques and international literature. The aim of the study was to investigate: i) relevant and combined determinants of the development, management and outcome of a representative patient cohort (n ¼ 9.991) with acute appendicitis enrolled in a prospective unicenter study through a time period of 27 years (middle Europe), and ii) the frequency and impact of specific categories (e.g., characteristics of the medical history, clinical and intraoperative findings, complications), correlation and relative risk factors of the disease and its prognosis. From 01=1997 until 12=2006 198 TEM procedures were performed in 194 patients, 104 males, 90 females, mean age was 68.9 years (38-91), the median hospital stay was 8 days . No conversion to open technique had to be performed, no postoperative surgical complications were observed, one patient died 4 weeks postoperative due to liver failure following esophageal varices bleeding.


id: cord-015369-72cjogxz
author: nan
date: 2009
txt: ./txt/cord-015369-72cjogxz.txt
cache: ./cache/cord-015369-72cjogxz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103189/
doi: 10.1007/s10353-009-0461-1
abstract: nan
summary:
  Bei 2 Patienten wurde wegen eines Rezidivs eine neuerliche RFT mit liver packing notwendig, 5 Patienten wurden ohne Packing ein zweites mal abladiert und ein Patient unterzog sich einer linksseitigen Hemihepatektomie nach rechtsseitiger Ablation. Das laparoskopische Liver Packing ermöglicht eine ablative Therapie der Leber in Patienten, die mit den herkömmlichen Möglichkeiten nicht lokal therapierbar sind. Zusammenfassend lässt sich anhand der hier vorliegenden Studie zeigen, dass die Therapie von VSM mittels ELT mit 1470-nm-Diodenlaser und Radialfaser eine sowohl minimalinvasive als auch sichere und effiziente Therapieoption darstellt und eine hohe frühzeitige Erfolgsrate bei niedrigem Schmerzniveau aufweist.In weiteren Studien muss geprueft werden, ob aehnlich gute Resultate auch bei weiterer Absenkung des Energienivaus zu erreichen sind. Patients who underwent R0 resection for colon and rectal cancer during the period 1995-2000 showed a significantly improved 5-year survival rate compared to those operated on between 1991 and 1995.

title:
  50th Annual Meeting of the Austrian Society of Surgery. Vienna, June 18–20, 2009. Guest Editors: Albert Tuchmann, Erhard Schwanzer, Benedikt Walzel


id: cord-015370-4jfgsic7
title: 55th Annual Meeting of the Austrian Society of Surgery: Graz, June 25—27, 2014
author: nan
date: 2014-06-03
txt: ./txt/cord-015370-4jfgsic7.txt
cache: ./cache/cord-015370-4jfgsic7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103191/
doi: 10.1007/s10353-014-0261-0
abstract: nan
summary:
  Obwohl die fehlerhafte Aufklärung durch Ärzte unter Juristen schon länger ein "Renner" ist, hat sich in der Praxis häufig noch nicht herumgesprochen, wie und vor allem wann der Patient vor einem chirurgischen Eingriff aufgeklärt werden muss. Objective: This study aimed to investigate the effect of single and combined baseline concentrations of b vitamins on postoperative survival of vascular surgery patients over a time of 8.5 years in a region without folate fortification. Laparoscopic resection of 2 gastric duplication cysts in a pediatric patient: report of a case Ergebnisse: Mit Ausnahme von 6 der Mädchen mit 32 funktionellen Zysten, die konservativ behandelt wurden, wurden alle anderen Tumoren nach Durchführung einer Schnellschnittuntersuchung reseziert, bei 2 Mädchen mit malignen Tumoren war nur ein Tumordebulking möglich. Methods: Twenty-two patients, who underwent endoscopic band removal between June 2002 and December 2013, were ret-und in manchen Fällen ist die Amputation der einzige Ausweg, wenn auch diese sorgfältig gegen Risiko und Nutzen einer komplexen Rekonstruktion abgewogen werden muss, um im Endeffekt dem Patienten ein paar Jahre mit hoher Lebensqualität zu ermöglichen.


id: cord-016372-opojt70e
title: Postoperative Care of the Cardiac Surgical Patient
author: DiMarco, Ross F.
date: 2010
txt: ./txt/cord-016372-opojt70e.txt
cache: ./cache/cord-016372-opojt70e.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120630/
doi: 10.1007/978-0-387-77893-8_47
summary:
  Ninety percent of all postoperative open-heart patients demonstrate a transient low cardiac output (LCO) related to the release of oxygen free radicals in response to the induced inflammatory state of cardiopulmonary bypass, or from ischemic/reperfusion injury as a result of cardioplegic arrest. Doses greater than 2 mcg/ min (>0.03 mcg/kg/min) produce effects that cause vasoconstriction with an increased SVR potentially decreasing cardiac output further as well as increasing myocardial oxygen demand. 88, 89 The indications for IABP counterpulsation are perioperative ischemia, mechanical complications of myocardial infarction (such as acute mitral regurgitation, ventricular septal defect, and cardiogenic shock), postoperative low cardiac output states not responsive to moderate doses of inotropic agents, and for the acute deterioration of myocardial function to provide temporary support or a bridge to transplantation. Inotropic effect of triiodothyronine in low cardiac output following cardioplegic arrest and cardiopulmonary bypass: an initial experience in patients undergoing open-heart surgery

abstract:
  The subspecialty of interventional cardiology began in 1977. Since then, the discipline of interventional cardiology has matured rapidly, particularly with regards to ischemic heart disease. As a result, more patients are undergoing percutaneous catheter interventional therapy for ischemic heart disease and fewer patients are undergoing surgical myocardial revascularization. Those patients referred for surgical revascularization are generally older and have more complex problems. Furthermore, as the population ages more patients are referred to surgery for valvular heart disease. The result of these changes is a population of surgical patients older and sicker than previously treated.


id: cord-018363-qr1pk78u
title: Consultative and Comanagement
author: Casey, Ashley
date: 2015-10-10
txt: ./txt/cord-018363-qr1pk78u.txt
cache: ./cache/cord-018363-qr1pk78u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123218/
doi: 10.1007/978-3-319-23748-0_2
summary:
  Results of physical examination are as follows: temperature, 38.9 °C (102.1 °F); heart rate, 116 bpm; blood pressure, 96/60 mmHg; respiratory rate, 35 breaths/min; and O 2 saturation, 74 % on 100 % O 2 with a nonrebreather mask. In the past 20 min, the patient has become abruptly short of breath, hypoxic, and severely hypotensive with a blood pressure of 72/palpation mm Hg. On physical exam, she is obtunded and in serve respiratory distress. A 64-year-old female with a past medical history signifi cant for type 2 diabetes mellitus is admitted with increasing shortness of breath. A meta-analysis of 15 studies reports that hyperglycemia increased both in-hospital mortality and incidence of heart failure in patients admitted for acute myocardial infarction. Continuing warfarin treatment at the time of pacemaker in patients with high thrombotic risk was associated with a lower incidence of clinically signifi cant device-pocket hematoma, as opposed to bridging with heparin.

abstract:
  This chapter covers the role of the hospitalist as a consultant and their interaction with surgical specialties. Included are discussions of perioperative care in the hospital and clinic. Oral and parenteral nutrition for the hospitalized patient are examined. A special emphasis is placed on palliative care for the hospitalized patient. Comanagement of surgical patients with an emphasis on orthopedics is reviewed.


id: cord-028285-n4dommet
title: COVID-19: What are the challenges for NHS surgery?
author: Weilongorska, Natasha L.
date: 2020-07-02
txt: ./txt/cord-028285-n4dommet.txt
cache: ./cache/cord-028285-n4dommet.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329670/
doi: 10.1016/j.cpsurg.2020.100856
abstract: nan
summary:
  With there being a short interval from the time of the first COVID-19 case presentation, to the development of a global pandemic, validated management algorithms to support changes in operative strategies are lacking. The key components of NHS preoperative patient screening for COVID-19 are: structured questionnaires with temperature monitoring, viral real-time polymerase chain reaction (RT PCR) for SARS-CoV-2, and chest imaging. Full PPE (fluid resistant gown, double gloving, visor or goggles, fit-tested FFP3 mask or respirator, disposable hat, shoe covers) should be worn in the operating rooms for any suspected or positive COVID-19 case, for AGP 38 (Table 3) , and for procedures for which the risk is unknown. All surgical cases require a discussion about the patient''s COVID-19 status, the degree of aerosol risk for each part of the procedure (induction of anaesthesia, extubation, and for all operative phases), with PPE requirement stated for each stage.


id: cord-032067-eemlg0px
title: Same Day Bilateral Cataract Surgery—Who Benefits?
author: Masket, Samuel
date: 2020-09-18
txt: ./txt/cord-032067-eemlg0px.txt
cache: ./cache/cord-032067-eemlg0px.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498406/
doi: 10.1016/j.ophtha.2020.08.017
abstract: nan
summary:
  1 The proponents of SDBCS indicate that given current surgical techniques, use of prophylactic intracameral antibiotics and undergoing second eye surgery with a new sterile prep and drape, a new fully sterilized instrument set, and separate batches of disposable products from disparate lots should reduce risks to infinitesimally small numbers; they also indicate that the world''s literature has but few cases of bilateral infection after surgery. Although third-party reimbursement strategies vary across countries and healthcare delivery systems, in the United States, physicians and surgery centers are reimbursed just 50% for second eye surgery performed on the same calendar day under traditional fee-for-service Medicare; this creates a significant financial disincentive for SDBCS. At present, at least with regard to surgery in the United States under traditional Medicare, it appears as though the surgeon is financially compromised and the patient put at greater risk, whereas the third-party payer is the ultimate beneficiary of SDBCS.


id: cord-032781-85hrb0vc
title: Featured papers in the October Issue
author: Chen, Herbert
date: 2020-09-28
txt: ./txt/cord-032781-85hrb0vc.txt
cache: ./cache/cord-032781-85hrb0vc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521450/
doi: 10.1016/j.amjsurg.2020.09.001
abstract: nan
summary:
  We are highlighting these eight thought-provoking editorials: COVID 19: Surgery & the question of race, 11 Reforming our general surgery residency program at an urban level 1 Trauma Center during the COVID-19 pandemic: Towards maintaining resident safety and wellbeing, 12 COVID-19 and surgical training in Italy: Residents and young consultants perspectives from the battlefield, 13 The volume of recyclable polyethylene terephthalate plastic in operating rooms, 14 Immersive Virtual Reality in surgery and medical education: diving into the future, 15 Educational benefits of an acute care surgery rotation during the medical student surgical clerkship, 16 Do We Know Our Patients'' Goals? Delving deeper into disparity: the impact of health literacy on the surgical care of breast cancer patients Delving deeper into disparity: the impact of health literacy on the surgical care of breast cancer patients Invited commentary on "delving deeper into disparity: the impact of health literacy on the surgical care of breast cancer patients


id: cord-032915-r6qguo8q
title: The dilemma faced by a budding cardiothoracic surgeon in India—a first hand account
author: Paul, Saptarshi
date: 2020-09-30
txt: ./txt/cord-032915-r6qguo8q.txt
cache: ./cache/cord-032915-r6qguo8q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527145/
doi: 10.1007/s12055-020-01045-5
summary:
  In this article, I have tried to make young surgeons aware of what they will face during their residency tenure and also to attend to some of their worries prior to selecting cardiac surgery as a career option. As stated by Burt et al., increasing years of surgeon experience is associated with improved operative efficiency and long-term survival in valvular cardiac surgery [1] . As of 2019, the SYNTAXES (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery Extended Survival) trial, which is a 10-year follow-up study of the SYNTAX trial, has shown that patients with threevessel disease had a survival advantage with CABG versus PCI at 10 years. I implore all the young surgeons to observe the post operative management intently, as it has as much implications on the prognosis of the patient as the surgery itself. Influence of experience and the surgical learning curve on long-term patient outcomes in cardiac surgery

abstract:
  Cardiothoracic surgery is undoubtedly one of the most glamorous and exciting surgical fields on earth. The field requires passionate and hardworking youngsters who are always willing to learn. Bright young surgeons should know what is going to be on their platter once they have decided to take the plunge into cardiac surgery. This article is a fruit of my 3 years of residency experience and my ongoing stint as an assistant professor. In this article, I have tried to make young surgeons aware of what they will face during their residency tenure and also to attend to some of their worries prior to selecting cardiac surgery as a career option.


id: cord-033829-56ka60bc
title: Editor’s Perspective November 2020
author: Lau, Joseph W.Y.
date: 2020-10-16
txt: ./txt/cord-033829-56ka60bc.txt
cache: ./cache/cord-033829-56ka60bc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7562922/
doi: 10.1016/j.ijsu.2020.10.002
abstract: nan
summary:
  In the October 2020 issue of Editor''s Perspective, I focused on the major advances in fibre-optic endoscopic surgery, a branch of minimally invasive surgery which marks the major developments of Surgery 3.0. The third article is a systematic review and meta-analysis on 22 randomized trials looking at the "effect of acute normovolemic hemodilution on coronary artery bypass grafting". The fourth article on "Robotic surgery for gastric cancer in the west" concluded that robotic gastrectomy had comparable short-term outcomes as open and laparoscopic approaches. The fifth article comparing "the efficacy and safety of thoracic endovascular aortic repair (TEVAR) versus open repair or optimal medical therapy for acute type B aortic dissection" concluded that TEVAR produced better 30 days/in-hospital mortality than open surgery and better long-term mortality than optimal medical therapy. The fifth article determined whether laparoscopic surgery to be safe and effective for management of patients with colorectal cancer liver metastases in a population-based analysis in Ontario, Canada.


id: cord-034185-e0am7pa6
author: Piccioni, Federico
date: 2020-10-23
txt: ./txt/cord-034185-e0am7pa6.txt
cache: ./cache/cord-034185-e0am7pa6.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7582032/
doi: 10.1186/s13741-020-00159-z
summary:
  We do not recommend the routine use of either continuous positive airway pressure (CPAP) or non invasive ventilation (NIV) to prevent postoperative pulmonary complications, prolonged length of stay, and mortality (both in ICU and in hospital) in patients undergoing major thoracic surgery. Level of evidence: Fair Strength of recommendation: C A meta-analysis of 45 studies including almost 5800 patients showed that a single perioperative dose of intravenous dexamethasone resulted in significant reductions in pain scores and opioid use, and was associated with shorter stays in the post-anesthesia recovery room, compared with placebo or antiemetic treatment (Waldron et al. Level of evidence: Fair Strength of recommendation: A Multiple clinical trials have shown that, in patients undergoing open thoracotomy or other major surgical procedures, thoracic epidural analgesia (TEA) is superior to intravenous opioid administration in terms of postoperative pain relief, length of hospital stay, and incidence of postoperative complications (Hazelrigg et al.

title:
  Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care

abstract:
  INTRODUCTION: Anesthetic care in patients undergoing thoracic surgery presents specific challenges that require a multidisciplinary approach to management. There remains a need for standardized, evidence-based, continuously updated guidelines for perioperative care in these patients. METHODS: A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, was established to develop recommendations for anesthesia practice in patients undergoing elective lung resection for lung cancer. The project addressed three key areas: preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventive Services Task Force criteria. RESULTS: Recommendations for intraoperative care focus on airway management, and monitoring of vital signs, hemodynamics, blood gases, neuromuscular blockade, and depth of anesthesia. Recommendations for postoperative care focus on the provision of multimodal analgesia, intensive care unit (ICU) care, and specific measures such as chest drainage, mobilization, noninvasive ventilation, and atrial fibrillation prophylaxis. CONCLUSIONS: These recommendations should help clinicians to improve intraoperative and postoperative management, and thereby achieve better postoperative outcomes in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.


id: cord-035258-nff6gfik
title: Pulmonary Complications of Cardiac Surgery
author: Tanner, Tristan George
date: 2020-11-11
txt: ./txt/cord-035258-nff6gfik.txt
cache: ./cache/cord-035258-nff6gfik.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655908/
doi: 10.1007/s00408-020-00405-7
summary:
  Pulmonary complications are common in patients who undergo cardiac surgery with outcomes such as pneumonia, pulmonary embolism, ventilation longer than 24 h, and pleural effusions necessitating drainage being reportable to the Society of Thoracic Surgeons [1] . Risk factors for postoperative bleeding in cardiac surgery patients include advanced age, low body weight, nonelective surgery, CPB time over 150 min, high complexity of procedure, perioperative use of antiplatelet agents, and use of over 5 bypass grafts [58] . Operative risk factors include low cardiac output syndrome, more than 3 U of packed RBCs (or massive transfusion), isolated valve surgery, and development of postoperative pneumonia [68, 69] . While routine use of the pulmonary artery catheter became less prevalent over the previous decades, it still holds a central role in the postoperative care of cardiac surgery patients. The incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of cardiac surgery patients: a prospective nested casecontrol study

abstract:
  Cardiothoracic surgery posits an arrangement of large, significant hemodynamic, and physiologic alterations upon the human body, which predisposes a patient to develop pathology. The care of these patients in the postoperative realm requires an astute physician with deep understanding of the cardiopulmonary system, who is able to address subtle developing problems promptly, before the patient suffers further sequelae. In this review, we describe the presentation and management of an assortment of important complications which occur in the pulmonary system. In addition, we aim to shed better light upon how the physiology of a patient responds to the condition of cardiothoracic surgery.


id: cord-104463-btr5h70l
title: COVID-19 pandemic and gynaecological endoscopic surgery
author: Ertan, Saridogan
date: 2020-05-07
txt: ./txt/cord-104463-btr5h70l.txt
cache: ./cache/cord-104463-btr5h70l.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363240/
doi: nan
abstract: nan
summary:
  The authors emphasise that there is a theoretical but unproven risk of transmission during laparoscopic procedures because the viral RNA is present in the blood of 1-15% of the patients and that presence of artificial pneumoperitoneum is likely to generate aerosol due to escape of CO 2 which may contain the virus within droplets of blood or the surgical smoke. This raises further questions as to whether there is a real risk of transmission of infection from exposure to blood either in the form of air droplets or surgical smoke during surgery. Whilst there is uncertainty about the transmission through surgical smoke or the escaping CO 2 during laparoscopic surgery, what is clearer is that the virus is more likely to infect healthcare professionals during intubation or extubation for general anaesthesia (anaesthetic team), or during procedures involving the upper respiratory tract (such as Ear-Nose-Throat surgeons). COVID-19 Pandemic and and gynaecological laparoscopic surgery: knowns and unknowns Facts Views Vis Obgyn


id: cord-253318-nlk8pjv2
author: Roberti, Fabio
date: 2020-05-06
txt: ./txt/cord-253318-nlk8pjv2.txt
cache: ./cache/cord-253318-nlk8pjv2.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020309451
doi: 10.1016/j.wneu.2020.04.235
summary:
  Abstract We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and "off-label" use of recombinant human bone morphogenetic protein-2 (rhBMP-2), treated successfully with the use of a minimally invasive tubular approach. We report a case of symptomatic heterotopic bone formation following lumbar spinal revision surgery and posterolateral fusion with rhBMP-2, successfully treated using a minimally invasive tubular approach and provide documentation of the technical aspect of the procedure. In light of the absence of significant low back pain, the predominance of radicular symptoms, the absence of mechanical instability and the presence of bilateral facet arthrodesis, as well as the history of previous lumbar surgeries and associated medical comorbidities, we felt a minimally invasive approach was an appropriate option to be selected in this case and the patients concurred with this informed decision. In the presented case we found the use of minimally invasive techniques to be of benefit for the removal of heterotopic bone formation following lumbar spine fusion with rhBMP-2.

title:
  Minimally invasive lumbar decompression and removal of symptomatic Heterotopic bone formation after spinal fusion with rhBMP-2

abstract:
  Abstract We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and “off-label” use of recombinant human bone morphogenetic protein-2 (rhBMP-2), treated successfully with the use of a minimally invasive tubular approach.


id: cord-253567-a7qg8546
title: Comment on: Should Bariatric Surgery be Offered to Prisoners?
author: Friedman, Danielle T.
date: 2020-08-11
txt: ./txt/cord-253567-a7qg8546.txt
cache: ./cache/cord-253567-a7qg8546.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32888785/
doi: 10.1016/j.soard.2020.08.001
abstract: nan
summary:
  The authors of this opinion piece raise the thought-provoking argument that in order to ensure equity in healthcare for imprisoned persons, and to provide optimal treatment for prisoners with obesity and its health-related comorbidities, access to bariatric surgery should be provided for qualifying individuals within the prison system. This underlines the critical argument for bariatric surgery in an imprisoned population, despite its challenges: providing these patients access to the most effective treatment for obesity and its comorbidities could help to correct dramatic racial and socioeconomic healthcare disparities impacting prisoners. Despite the promise of this proposal and the above arguments in favor of bariatric surgery in the prison population, there are numerous concerns, obstacles, and counterarguments that must be considered. In addition, one could readily see the moral, political, and social justice issues in a situation where a prisoner convicted of murder is able to receive taxpayer-funded bariatric surgery, while equally qualified family members of the victim are unable to afford the same opportunity due to insurance and access reasons.


id: cord-257824-qz6yxuph
title: Current impact of Covid-19 pandemic on Spanish plastic surgery departments: a multi-center report
author: Fuertes, Víctor
date: 2020-05-19
txt: ./txt/cord-257824-qz6yxuph.txt
cache: ./cache/cord-257824-qz6yxuph.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32836886/
doi: 10.1007/s00238-020-01686-0
summary:
  title: Current impact of Covid-19 pandemic on Spanish plastic surgery departments: a multi-center report The total amount of procedures currently being performed ranged from 0 to 44% of the figures before the coronavirus outbreak, except for one department, with elective surgery mainly affected. The total amount of procedures currently being performed ranged from 0 to 44% of the figures before the coronavirus outbreak (Fig. 1a, b) ; except for one hospital, that was declared to maintain the same surgical activity (100%). Some of the more prevalent measures include screening protocols for Coronavirus among patients and workers, increasing hygiene measures, reducing the number of visitors per patient, directing burn patients who tested positive to other units and trying to apply day-care/ delay surgeries whenever this is possible. This might pose a challenge against the delivery of emergency surgeries and cancer care to our community if this pandemic lasts for a prolonged period long time According to our analysis, reductions of about 20-50% in the total number of consultants per team may lead to this situation.

abstract:
  BACKGROUND: After its initial description in China, Covid-19 is hitting nations across the world, with Spain as the third country in number of deaths, after the USA and Italy. Similarly to what is happening in other countries, an important reduction in available operating rooms is affecting our departments. In this study, we aim to know how Covid-19 pandemic is affecting the delivery of plastic surgery services in Spain. METHODS: A questionnaire addressing some of our concerns about how the Coronavirus crisis might severelyimpact our specialty has been sent to the heads of the divisions of plastic surgery of several hospitals across Spain. RESULTS: A total of 12 plastic surgery departments from different hospitals across the country agreed to participate in the survey. Most plastic surgery teams will need to maintain 50–80% of their staff in order to be able to offer emergency and undelayable oncological procedures. The total amount of procedures currently being performed ranged from 0 to 44% of the figures before the coronavirus outbreak, except for one department, with elective surgery mainly affected. Microsurgical cases have been massively discontinued during this crisis. CONCLUSIONS: Plastic surgery delivery in the Spanish Health System is being severely impacted as a collateral damage from this pandemic. Most of the elective surgery is currently stopped. Our departments seem to be vulnerable regarding their capacity to keep offering emergency care. Level of evidence: not ratable (multi-center survey)


id: cord-258402-9s57thvn
author: Dabas, Vineet
date: 2020-09-10
txt: ./txt/cord-258402-9s57thvn.txt
cache: ./cache/cord-258402-9s57thvn.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32934420/
doi: 10.1007/s43465-020-00252-x
summary:
  INTRODUCTION: With increasing prevalence of coronavirus cases (including among health care providers), the current advice for orthopaedic surgeons is to favor non-operative management of most injuries and reduce face-to-face follow-up. The standard operating procedures (SOPs) were implemented which were based upon the recommendations of ICMR, Ministry of Health and Family Welfare, GOI and Indian Orthopaedic Association (IOA) [10] , and targeted to provide optimum healthcare at a minimum risk to the treating team as well as other patients admitted to the hospital. Among the non-COVID-19 suspects, who were shifted to non-isolation zone, those who could be managed conservatively were given adequate primary treatment like fluids, analgesics and splintage and were discharged at the earliest so as to minimize the risk of infection transmission to them as well as health care workers.

title:
  Management of Orthopaedic Accidental Emergencies Amidst COVID-19 Pandemic: Our Experience in Preparing to Live with Corona

abstract:
  INTRODUCTION: With increasing prevalence of coronavirus cases (including among health care providers), the current advice for orthopaedic surgeons is to favor non-operative management of most injuries and reduce face-to-face follow-up. We present our experience in managing the patients at Government-run non-COVID-19 trauma center in Delhi in an algorithmic form. Our standard operating protocols were mainly based on recommendations of Indian Orthopaedic Association and targeted to provide healthcare at a minimum risk to the treating team as well as other patients admitted to the hospital. METHODOLOGY: We describe the inflow, in-hospital management and outflow of patients at our facility during the lockdown period and in the following unlock period (from 23 March to 8 July 2020). Those patients who had absolute indications for surgery were offered surgery, while conservative treatment was more favored in those with relative indications. We also highlight the changes incorporated in OT settings as well as in rehabilitative and follow-up period. RESULTS: Following the described protocol helped us maintain a balance between the safety of patients and our front line workers which was evident by very low COVID-19-positive rate in admitted patients (4.22%) and health care providers (16.67%) in the above-mentioned time period. CONCLUSIONS: We need to be prepared to cohabitate with this deadly Novel Coronavirus and adapt our surgical practices according to the need of the hour by minimizing surgical indications and strengthening the training in conservative principles.


id: cord-260253-kd9fw7fh
title: Author''s reply
author: Lei, Shaoqing
date: 2020-05-18
txt: ./txt/cord-260253-kd9fw7fh.txt
cache: ./cache/cord-260253-kd9fw7fh.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S2589537020301309
doi: 10.1016/j.eclinm.2020.100386
abstract: nan
summary:
  Thus, any infection long after surgery (say, 10 to 14 days after surgery) or those who contacted with confirmed cases of COVID-19 after surgery (such as the 3 excluded patients) were excluded. Additionally, we cannot exclude the possibility that there may be someone who got infected and performed surgery but maintained asymptomatic, despite this might be rare. as the authors estimated could only be the rate of unintentional surgery that activated latent infection. As for the number of patients in each group (surgical difficulties), we have presented the details of types of surgery and grading of surgical difficulty in Table 1 and Table 2 in our published article [1] . We appreciate the authors'' suggestion of providing detailed rates of infection and mortality etc. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection Perioperative management of patients infected with the novel coronavirus: recommendation from the joint task force of the chinese society of anesthesiology and the chinese association of anesthesiologists


id: cord-262556-gpnp06je
title: COVID-19: IFSO LAC Recommendations for the Resumption of Elective Bariatric Surgery
author: Behrens, Estuardo
date: 2020-08-22
txt: ./txt/cord-262556-gpnp06je.txt
cache: ./cache/cord-262556-gpnp06je.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32827292/
doi: 10.1007/s11695-020-04910-9
summary:
  RESULTS: The resumption of elective BMS must be a priority maybe similar to oncological surgery, when hospitals reach phase I or II, treating obesity patients in a NON-COVID area, avoiding inadvertent intrahospital contagion from healthcare provider, patients, and relatives. On December 2019, Wuhan, China, reported an outbreak of the coronavirus SARS-CoV-2 (COVID19) , an RNA virus that affects the respiratory system and has a high fatality rate especially in adults over the age of 60 and patients suffering obesity and its comorbidities [1] [2] [3] . Currently, the most effective treatment against obesity available is bariatric and metabolic surgery, which further resolves or improves the related comorbidities that are the same risk factors in developing a severe case of SARS-CoV-2. It is recommended that elective bariatric surgery be performed in medical facilities with the necessary infrastructure to treat obesity patients in a NON-COVID area.

abstract:
  BACKGROUND: COVID-19 pandemic varies greatly and has different dynamics in every country, city, and hospital in Latin America. Obesity increases the risk of SARS-CoV-2 infection, and it is one of the independent risk factors for the most severe cases of COVID-19. Currently, the most effective treatment against obesity available is bariatric and metabolic surgery (BMS), which further resolves or improves other independent risk factors like diabetes and hypertension. OBJECTIVE: Provide recommendations for the resumption of elective BMS during COVID-19 pandemic. METHOD: This document was created by the IFSO-LAC Executive Board and a task force. Based on data collected from a survey distributed to all IFSO-LAC members that obtained 540 responses, current evidence available, and consensus reached by other scientific societies. RESULTS: The resumption of elective BMS must be a priority maybe similar to oncological surgery, when hospitals reach phase I or II, treating obesity patients in a NON-COVID area, avoiding inadvertent intrahospital contagion from healthcare provider, patients, and relatives. Same BMS indication and types of procedures as before the pandemic. Discard the presence of SARS-CoV-2 within 72 h prior to surgery. Continues laparoscopic approach. The entire team use N95 mask. Minimum hospital stays. Implement remote visits for the follow-up. CONCLUSION: Resumption of elective BMS is crucial because it is not only a weight loss operation but also resolves or improves comorbidities and appears to be an immune restorative procedure of obese patients in the medium term, offering them the same probability of contracting COVID-19 as the regular population.


id: cord-263773-b8zbgaor
author: Novara, Giacomo
date: 2020-04-13
txt: ./txt/cord-263773-b8zbgaor.txt
cache: ./cache/cord-263773-b8zbgaor.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.eururo.2020.04.015
doi: 10.1016/j.eururo.2020.04.015
abstract: nan
summary:
  title: Risk of SARS-CoV-2 Diffusion when Performing Minimally Invasive Surgery During the COVID-19 Pandemic Based on the high prevalence of SARS-CoV-2 in stools [4] , some reports on the presence of other viruses in Although, to the best of our knowledge, cases of this type of transmission have not been reported so far, this issue must be evaluated with particular caution for urologists still allowed to perform minimally invasive procedures during the COVID-19 pandemic. This is especially important when removing trocars at the end of a procedure, when making a skin incision for specimen retrieval, and in the rare J o u r n a l P r e -p r o o f cases of conversion to open surgery. Unfortunately, even urologists who have the privilege of being able to continue performing minimally invasive surgery must rethink details of their activities to minimize the risks for patients and health care workers. Considerations in the triage of urologic surgeries during the COVID-19 pandemic Urology practice during COVID-19 pandemic

title:
  Risk of SARS-CoV-2 Diffusion when Performing Minimally Invasive Surgery During the COVID-19 Pandemic


id: cord-264631-rsmcos7j
author: Bregman, Dana E
date: 2020-07-30
url: https://doi.org/10.1093/asj/sjaa225
doi: 10.1093/asj/sjaa225
title:
  Estimated National and Regional Impact of COVID-19 on Elective Case Volume in Aesthetic Plastic Surgery

abstract:
  BACKGROUND: In efforts to help alleviate the strain placed on healthcare during the COVID-19 pandemic, The American Society of Plastic Surgery (ASPS) recommended suspending elective procedures on March 19, 2020. When this suspension was enacted, it was unknown when cases would resume. OBJECTIVES: This analysis aims to estimate the regional economic impact of the pandemic specifically with regards to elective, aesthetic surgical procedures. As knowledge regarding the effects of the pandemic has grown, the authors then evaluated the accuracy of our projected estimates when compared to actual events. METHODS: Using the ASPS 2018 Plastic Surgery Statistics Report, regional case volume and surgeons’ fees were obtained for the top five aesthetic procedures. Models developed by the Institute for Health Metrics and Evaluation (IHME) were used to estimate the anticipated duration of suspension by using the date that no ventilators would be required to for COVID-19 patients. This duration was used to calculate the volume of cases that would not occur. RESULTS: These estimates predict up to 1.3 billion fewer dollars will be collected in surgeons’ fees, representing a 20% loss compared to 2018. The South Atlantic region is predicted to have the greatest number of OR days lost; However, the Mountain and Pacific regions are estimated to have the greatest loss in case volume and surgeons’ fees. CONCLUSIONS: The cumulative impact of the pandemic on life, society, and the economy is tremendous. This analysis may help guide surgeons’ responses during and after the crisis.


id: cord-265014-ic5drg5l
author: Serebrakian, Arman T.
date: 2020-09-29
url: https://doi.org/10.1097/gox.0000000000003247
doi: 10.1097/gox.0000000000003247
title:
  Webinar during COVID-19 Improves Knowledge of Changes to the Plastic Surgery Residency Application Process

abstract:
  BACKGROUND: The COVID-19 pandemic has significantly impacted residency application process for all specialties, including plastic surgery residency. Almost all plastic surgery residency programs have suspended visiting sub-internship rotations. This study quantifies the impact of a webinar through an analysis of poll questions and a post-webinar survey sent to all registered participants. METHODS: A dedicated webinar was organized and held by the Harvard Plastic Surgery Residency Training Program. All attendees were asked several poll questions during the webinar. The 192 participants were also sent a post-webinar survey. RESULTS: The response rate was 68.2% (n = 131). Respondents were more confident about matching into a plastic surgery residency program at the end of the webinar compared with before the webinar (P < 0.001). Respondents who did not have a plastic surgery residency program at their home institution were less confident at the start of the webinar (P = 0.009). In addition, respondents who had not taken time off for research or for other endeavors during or after medical school were less confident about their chances to match at the start of the webinar (P = 0.034). CONCLUSIONS: An online webinar program increased confidence levels of medical students interested in applying for residency positions in plastic surgery. Residency programs should consider webinars as a method to inform and assist medical students during the upcoming application season.


id: cord-266842-fr7kj186
title: Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home
author: McKechnie, Tyler
date: 2020-05-01
txt: ./txt/cord-266842-fr7kj186.txt
cache: ./cache/cord-266842-fr7kj186.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32404672/
doi: 10.1097/sla.0000000000003999
abstract: nan
summary:
  title: Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home Computer-and phone-based technologies provide access to intraoperative video recordings, virtual reality (VR) operating room simulations, and other interactive surgical platforms. 3 The aim of the present article is to provide an overview of the available computerand phone-based platforms accessible at home for surgical trainees who currently have limited surgical exposure given the ongoing COVID-19 pandemic. Currently, over 20 computer-based platforms, ranging over nine surgical specialties, are available on the internet and are accessible from home. Fifteen computer-based platforms are freely accessible, one platform (Incision Academy) is offering a four-week free trial during the COVID-19 pandemic, and seven platforms require paid accounts. This is a free platform that organizes over 400 peer-reviewed articles, has over 1,000 interactive clinical images, and allows for self-assessment. It is an interactive, virtual reality platform that allows the user to progress through the key steps of an operation.


id: cord-270214-5bjow148
title: Safe Colorectal Surgery in the COVID-19 Era – A Singapore Experience
author: Tan, Winson Jianhong
date: 2020-04-30
txt: ./txt/cord-270214-5bjow148.txt
cache: ./cache/cord-270214-5bjow148.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32429009/
doi: 10.3393/ac.2020.04.21
abstract: nan
summary:
  In this article, we share our colorectal unit''s workflow ( Fig. 1 ) and recommendations (Table 1) for safe practice in the COVID-19 era. Workflow for patients undergoing elective colorectal procedures in the COVID-19 era: Patients who have any travel history within 14 days, or has contact with any member of the public who is positive for COVID-19 or on home quarantine, or has new onset of flu-like symptoms will be advised on postponement of procedure. Unlike MIS, the exposure of the surgeon to smoke inhalation is likely higher in open surgery which raises the possibility of COVID-19 transmission. For COVID-19 cases, surgery is performed in a dedicated negative pressure OR. Secondly, the appropriate PPE in this era needs to be reviewed and perhaps all OR staff should be in N95 respirators for all colorectal procedures until there is more evidence regarding transmission risk during surgery.


id: cord-270382-z966wufy
author: Sultania, Mahesh
date: 2020-05-22
txt: ./txt/cord-270382-z966wufy.txt
cache: ./cache/cord-270382-z966wufy.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1368837520302505
doi: 10.1016/j.oraloncology.2020.104814
summary:
  They suggest neoadjuvant chemotherapy/oral metronomic therapy in locally advanced oral cancers or to defer surgery until progression [4] Dr. Varghese explains about the situation in the state of Kerala in India and the clearance by state government to perform RT PCR for Covid19 among all patients undergoing cancer surgeries, which is yet not a practice in other parts of India [5] . We are facing many challenges like resource constraints, majority of the population being from low socioeconomic status without health insurance, patients present in locally advanced stage and waiting list of surgery is 2 to 3 months with a risk of tumor progression and no COVID testing for surgical patients if not from containment zone. Metronomic therapy is one of the options for patient with locally advanced tumor who have been planned for elective oral cancer surgery which is easily deliverable, minimally toxic, home based and cost effective [6] .

title:
  Oral Cancer Surgery and COVID pandemic – Metronomic Therapy shows a promising role while awaiting surgery

abstract:
  • Metronomic therapy is a good option for locally advanced oral cancers in COVID-19 pandemic time. • In the present situation there is a need for a therapy that ensure patients remain operable while awaiting surgery. • Metronomic therapy is easily deliverable, minimally toxic, home based and cost effective.


id: cord-272061-r4a4cvug
author: Rossella, Elia
date: 2020-09-04
txt: ./txt/cord-272061-r4a4cvug.txt
cache: ./cache/cord-272061-r4a4cvug.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1748681520304149
doi: 10.1016/j.bjps.2020.08.081
abstract: nan
summary:
  title: Plastic Surgery in the time of Coronavirus in Italy. We reviewed the data of all the patients admitted to our Plastic Surgery Unit, which is located in a COVID hospital, from our institution digital databases from the 1 st to the 31 st of March 2020 and we compared those data with the ones of the previous 5 years. Quite for this reason, ten patients were admitted to our Burn Center this month alone. Not even the prison system has remained foreign to the previous observations, with reference to patients who had needed recovery and treatment in a plastic surgery department. The Plastic Surgery Community continues to work and to fight the same universal battle with the same sense of responsibility. Responsibility to be part of the cure and not part of the disease 2 . For instance, dedicated plastic surgery teams comprising attending physicians and residents have been established in our Center.

title:
  Plastic Surgery in the time of Coronavirus in Italy. Can we really say “Thanks God we are plastic surgeons?”


id: cord-273929-kpcmy9x8
title: The impact of COVID‐19 on Head and Neck surgery, education, and training
author: Shah, Jatin P.
date: 2020-04-25
txt: ./txt/cord-273929-kpcmy9x8.txt
cache: ./cache/cord-273929-kpcmy9x8.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/hed.26188
doi: 10.1002/hed.26188
abstract: nan
summary:
  With a fragile future, how do we conduct our day-to-day activities, and plan to retain our robust education and training programs, to educate and train the next generation of head and neck surgeons? 1 The drastic changes that have affected our work and life during the past 2 months have taught us that remote communications, education, teaching, learning and training are possible and have to be incorporated in our current systems. The IFHNOS has taken a lead on developing the first remote learning online fellowship program in head and neck surgery and oncology, which has been in existence for the past 6 years. In head and neck surgery, the stringent follow-up schedule was designed on the basis that nearly 80% of the patients who were to recur, would have recurred in the first 24 months, with a median time to recurrence of 9 months. The impact of COVID-19 on Head and Neck surgery, education, and training


id: cord-274782-yymo9i6r
title: Management of orthopedic oncology patients during coronavirus pandemic
author: Şahbat, Yavuz
date: 2020-07-02
txt: ./txt/cord-274782-yymo9i6r.txt
cache: ./cache/cord-274782-yymo9i6r.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32617984/
doi: 10.1002/jso.26092
summary:
  At first glance, the coronavirus disease 2019 (COVID‐19) pandemic and orthopedics may seem to be unrelated disciplines, but the provision of healthcare services to patients who require them proves that these two fields are parts of the same whole. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. We obtained data from the hospital information system regarding all oncologic orthopedics and trauma surgery patients operated on and followed between 11 March 2020, the date of the first confirmed case of coronavirus in Turkey, and 11 May 2020.

abstract:
  The new measures implemented in hospitals also altered the operation of orthopedics and traumatology departments. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. Instead of thinking about the global emergence of the epidemic, it is time to act decisively. At first glance, the coronavirus disease 2019 (COVID‐19) pandemic and orthopedics may seem to be unrelated disciplines, but the provision of healthcare services to patients who require them proves that these two fields are parts of the same whole. Our experiences in treating neutropenic, lymphocytopenic, and chemotherapy patients seem to have proven beneficial during this process. We operated on 10 biopsy patients, 15 primary bone sarcomas, 9 soft tissue sarcomas, and 82 trauma patients within this time frame. Only three patients were suspected to have COVID‐19 before admission. The early identification, strict isolation, and effective treatment of these patients prevented any nosocomial infections and disease‐related comorbidities. This success is the result of the multidisciplinary cooperation of the Ministry of Health, our hospital, and our clinic.


id: cord-275266-e6omvo5x
author: Kort, Nanne P
date: 2020-07-07
txt: ./txt/cord-275266-e6omvo5x.txt
cache: ./cache/cord-275266-e6omvo5x.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32635761/
doi: 10.1177/1120700020941232
summary:
  7, 8 These economic factors will influence the decision to re-start elective total joint Resuming hip and knee arthroplasty after COVID-19: ethical implications for well-being, safety and the economy arthroplasty during the COVID-19 pandemic. This specific, informed consent (IC) for elective surgery in times of COVID-19 requires further discussion with the patient about higher risk of virus transmission including from healthcare workers, the long incubation period (up to 14 days), the variable nature of the disease from mild to fatal, and discussions regarding ceilings of care and the potential need for ventilation. In this challenging time, when reinstating elective surgery in a risky scenario with limited resources, surgeons have the responsibility to follow a shared decision-making process with the patient that includes an understanding of the legal aspects of complications, and COVID-19 specific, informed consent.

title:
  Resuming hip and knee arthroplasty after COVID-19: ethical implications for well-being, safety and the economy

abstract:
  Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of the obstacles ahead and realise that the health challenges and economic consequences of the COVID-19 pandemic are potentially devastating. We must also prepare to make difficult ethical decisions about restarting elective hip and knee arthroplasty. These decisions should be based on the existing evidence-base, reliable data, the recommendations of experts, and regional circumstances.


id: cord-275272-qdg8sqpy
author: Soares-Júnior, José Maria
date: 2020-06-16
txt: ./txt/cord-275272-qdg8sqpy.txt
cache: ./cache/cord-275272-qdg8sqpy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32578830/
doi: 10.6061/clinics/2020/e2063
abstract: nan
summary:
  In this context, based on a recent publication regarding patient safety in elective surgeries (9) (10) (11) , as well as on the law of access to treatment and laws related to women''s health care (23, 24) , we propose the inclusion of gynecological surgery cases, stratified as follows ( Figure 1 ): Emergency (o1h): Peritonitis by tubo-ovarian and/or pelvic abscess, necrotizing fasciitis in surgeries for pelvic and breast neoplasms; DOI: 10.6061/clinics/2020/e2063 Urgent (o24h): Postoperative infections, acute inflammatory abdomen (adnexal tortoise, myoma tortoise, ovarian cysts), hemorrhagic conditions (ovarian cysts); Elective urgent (o2 weeks): Surgeries for neoplasms of the lower genital tract and breast previously diagnosed by pathological examination; Essential Elective (42 to o3 months): Hysteroscopy for abnormal uterine bleeding (unknowledge causes, suspected malignancy, and menopausal transition), postmenopausal bleeding (suspected malignancy), cervical conization or looped electro excision procedure (to exclude neoplasm in the lower genital tract); Non-essential/elective surgery: Infertility procedures, family planning procedures (bilateral tubal ligation procedure).

title:
  Gynecology and women’s health care during the COVID-19 pandemic: Patient safety in surgery and prevention


id: cord-275833-c3zamfix
author: McElligott, Helen
date: 2020-09-02
txt: ./txt/cord-275833-c3zamfix.txt
cache: ./cache/cord-275833-c3zamfix.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S2468428720301404
doi: 10.1016/j.jvscit.2020.08.019
summary:
  Endovascular therapy offers a way by which peri-operative risk can be reduced for vascular patients, while also reducing the impact of acute surgery on intensive care unit capacity. This case reports the management of a patient with complex aorto-iliac occlusive disease via a hybrid endovascular approach in light of the above constraints, with a successful outcome. We report a case of a patient with acute-on-chronic TASC-II (Trans-Atlantic Inter-8 Society Consensus II) D aorto-iliac occlusive disease managed by covered endovascular 9 reconstruction of the aortic bifurcation (CERAB) as an alternative to open surgery in the era of 10 COVID-19. Early data has 16 highlighted the impact of SARS-Cov2 infection on post-operative outcomes, with mortality rates 17 as high as 40% in COVID-19-positive patients undergoing vascular surgery reported 10 . Concerns regarding post-operative mortality in the event of SARS-Cov2 infection, 7 critical care bed capacity and inpatient length of stay will undoubtedly lead to a re-imagining of 8 the role of endovascular therapy in the management of complex aorto-iliac occlusive disease.

title:
  Hybrid-CERAB (Covered Endovascular Reconstruction of the Aortic Bifurcation) Procedure is preferable to Aorto-Bi-Femoral Bypass for Limb-threatening Aortoiliac Occlusive Disease during the COVID-19 Crisis.

abstract:
  The COVID-19 pandemic is disrupting the provision of acute vascular surgery across the globe. Limited evidence regarding the impact of nosocomial infection on patient outcomes, as well as concerns regarding critical care capacity, will likely impact upon surgical decision making. Endovascular therapy offers a way by which peri-operative risk can be reduced for vascular patients, while also reducing the impact of acute surgery on intensive care unit capacity. This case reports the management of a patient with complex aorto-iliac occlusive disease via a hybrid endovascular approach in light of the above constraints, with a successful outcome.


id: cord-275985-rj0o7lg2
title: Choosing the new normal for surgical education using alternative platforms
author: Keller, Deborah S.
date: 2020-08-30
txt: ./txt/cord-275985-rj0o7lg2.txt
cache: ./cache/cord-275985-rj0o7lg2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32904575/
doi: 10.1016/j.mpsur.2020.07.017
summary:
  Social media (SoMe), a tool that uses electronic communications and applications to allow users create and share information in dynamic ways, can meet this challenge. The COVID-19 pandemic has indeed created an abrupt need for new and innovative end-to-end training solutions, as well as a greater willingness for trainers and trainees to use novel technologies for surgical education. Social media and digital learning tools may be the ideal alternative platforms to meet the changing needs in surgical training and professional development. 5 Applications of SoMe specific for surgical education include live dissemination of research from peer-reviewed journals, live tweeting at medical conferences, online journal clubs, transmission of news from professional societies and surgical departments, coordination of research collaborative groups, and consultations/general discussion to further medical learning. A prime example of this communication ability is a closed Facebook group the Robotic Surgery Collaborative, which allow surgeons to share de-identified cases, post informal polls, and exchange questions and experiences regarding particular techniques or practices (Figure 1 ).

abstract:
  The traditional methods for surgical education and professional development are changing, from a variety of external factors. The COVID-19 pandemic accelerated the pace innovative alternative tools are introduced into clinical practice, creating a new normal for teaching and training. In this new normal is the challenge to create durable changes for the future of surgical education. Social media (SoMe), a tool that uses electronic communications and applications to allow users create and share information in dynamic ways, can meet this challenge. SoMe is reshaping how we communicate and learn, and offers great benefits for effective, individualized surgical education. The limits for SoMe appear endless, and elements have already help establish digital surgery to help improve the precision and outcomes of surgery. As we work to define the new normal in surgical education and professional development, SoMe digital surgery will be critical for continued growth and progress.


id: cord-276676-lgt0rzob
title: Best Practice in Cardiac Anesthesia during the COVID-19 Pandemic: Practical Recommendations
author: Moka, Eleni
date: 2020-07-03
txt: ./txt/cord-276676-lgt0rzob.txt
cache: ./cache/cord-276676-lgt0rzob.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1521689620300495?v=s5
doi: 10.1016/j.bpa.2020.06.008
summary:
  Indeed, the pandemic has already affected cardiac surgery units in multiple ways: limited number of available ICU beds and ventilation sites, necessity to postpone or cancel elective and/or complex cardiac interventional procedures, patients developing COVID-19 post cardiac surgery, coronavirus patients necessitating urgent cardiac operations, cardiac anesthetists'' in-hospital transfer to staff and support ICUs in front of the pandemic, infected health care providers with consequent shortage of medical and nursing practitioners, restrictions in clinical meetings, and cancelation of training and continuing medical education [6, 8] . Based on the current understanding of COVID-19 pathophysiology and the clinical characteristics of cardiovascular surgical patients, in this review, the authors highlight related anesthesia concerns and provide practical recommendations in reference to perioperative planning and management of patients undergoing cardiac surgery, along with a focus on disease control and prevention in the times of COVID-19 outbreak.

abstract:
  The COVID-19 outbreak has influenced the entire health care system, including cardiac surgery. In this review, the authors reveal practical aspects that are important during the COVID-19 pandemic with regards to the safe delivery of cardiac anesthesia. Timing for operations of the cardio-vascular system may be well programmed, in most cases. Hence, the level of priorities must be defined for any single patient. The postponement of surgery may be convenient for most cases, if it is made in the best interest of the patient. The preanesthetic evaluation should keep attention to the respiratory history of the patient. Cardiac anesthesia is always implying some respiratory monitoring; hence the existing clinical situation of the patient’s respiratory system should be clear. In case of emergency surgery, the patient should be treated as if they potentially have or are at risk for the virus. In the case of a COVID-19 confirmed or suspected patient, attention must be made to preserve operating room and team integrity. The machineries are to be draped with plastic, in order to simplify the disinfection after the operation. Perioperative management of suspected or confirmed COVID-19 patients must strictly follow the most relevant international guidelines. This review article has synthesized the common aspect present in the most important of these.


id: cord-277803-7p1qu2rf
author: Rubino, Francesco
date: 2020-05-07
txt: ./txt/cord-277803-7p1qu2rf.txt
cache: ./cache/cord-277803-7p1qu2rf.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2213858720301571
doi: 10.1016/s2213-8587(20)30157-1
summary:
  Given the uncertainty regarding the effects and duration of the COVID-19 outbreak, combined with the progressive nature of obesity, diabetes, and related conditions, delaying bariatric and metabolic surgery could increase the risks for morbidity and mortality in surgical candidates.

title:
  Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery

abstract:
  The coronavirus disease 2019 pandemic is wreaking havoc on society, especially health-care systems, including disrupting bariatric and metabolic surgery. The current limitations on accessibility to non-urgent care undermine postoperative monitoring of patients who have undergone such operations. Furthermore, like most elective surgery, new bariatric and metabolic procedures are being postponed worldwide during the pandemic. When the outbreak abates, a backlog of people seeking these operations will exist. Hence, surgical candidates face prolonged delays of beneficial treatment. Because of the progressive nature of obesity and diabetes, delaying surgery increases risks for morbidity and mortality, thus requiring strategies to mitigate harm. The risk of harm, however, varies among patients, depending on the type and severity of their comorbidities. A triaging strategy is therefore needed. The traditional weight-centric patient-selection criteria do not favour cases based on actual clinical needs. In this Personal View, experts from the Diabetes Surgery Summit consensus conference series provide guidance for the management of patients while surgery is delayed and for postoperative surveillance. We also offer a strategy to prioritise bariatric and metabolic surgery candidates on the basis of the diseases that are most likely to be ameliorated postoperatively. Although our system will be particularly germane in the immediate future, it also provides a framework for long-term clinically meaningful prioritisation.


id: cord-278609-zxdd06ur
author: Sarac, Benjamin A.
date: 2020-08-03
txt: ./txt/cord-278609-zxdd06ur.txt
cache: ./cache/cord-278609-zxdd06ur.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/gox.0000000000003119
doi: 10.1097/gox.0000000000003119
summary:
  Data on individual and plastic surgery practice demographics, COVID-19 prevention measures, and procedures or services that were being performed or delayed were collected and analyzed. CONCLUSIONS: Plastic surgeons have seen a drastic decrease in the variety of procedures and services they are allowed to offer during the COVID-19 pandemic. 7 Survey results showed that of the surgeons who normally offer aesthetic services, up to 8% are continuing to perform some of these procedures, which may be a result of the pandemic-caused financial strain. Multiple national societies released recommendations on the approach to breast cancer and reconstructive surgery during the COVID-19 pandemic. 2 Survey results showed that oncologic breast surgery continued during the COVID-19 outbreak, which highlights a need for clear guidelines on breast reconstruction. Plastic surgeons have seen a drastic decrease in the variety of procedures and services they are allowed to offer during the COVID-19 pandemic.

title:
  The Impact of COVID-19-based Suspension of Surgeries on Plastic Surgery Practices: A Survey of ACAPS Members

abstract:
  The coronavirus disease 2019 (COVID-19) pandemic led to a drastic decline in the number of elective surgeries performed in the United States. Many national societies and local governments provided recommendations for surgeons to initially suspend and progressively resume elective surgery. The authors used a survey to the American Council of Academic Plastic Surgeons (ACAPS) to assess the effect on plastic surgeons. METHODS: An electronic survey questionnaire was distributed to 532 members of ACAPS. Data on individual and plastic surgery practice demographics, COVID-19 prevention measures, and procedures or services that were being performed or delayed were collected and analyzed. RESULTS: An estimated 161 members (30.2%) completed the survey. Changes in hospital policy were cited as the most common reason (89%) for determining which procedures were currently offered. Results vary by specialty. Notably, <10% of respondents who normally offered aesthetic procedures currently offered any procedures during the survey. Subspecialty-specific results and prevention measures when seeing clinic patients are further summarized and discussed. CONCLUSIONS: Plastic surgeons have seen a drastic decrease in the variety of procedures and services they are allowed to offer during the COVID-19 pandemic. To help plan a return to normalcy, surgeons should create and implement plans to protect patients and staff from coronavirus transmission, assure financial solvency, and consider the effects of delayed surgeries on both the physical and mental health of their patients. In doing so, surgeons and their patients will be better prepared in the event of a resurgence of the virus.


id: cord-283215-dgysimh5
author: Al-Jabir, Ahmed
date: 2020-05-12
txt: ./txt/cord-283215-dgysimh5.txt
cache: ./cache/cord-283215-dgysimh5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ijsu.2020.05.002
doi: 10.1016/j.ijsu.2020.05.002
summary:
  Prioritisation of surgical services during this pandemic must be a careful balance of patient needs and resource availability and the European Association of Urology Guidelines Office offer the following suggestions for factors that must be taken into account [3] Whilst there have been no publication of guidelines by any professional association for the management of stone surgery during the COVID-19 pandemic, there have been some guidance published by Proietti et al [48] suggesting telephone triage of patients followed by prioritisation based on stone size and location, the presence of any obstructive uropathy, patient symptoms, presence of any stents or nephrostomy tubes and any other complicating factors such as renal failure or a solitary kidney. 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.

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

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.


id: cord-285354-bp2dozzg
author: Costanzi, Andrea
date: 2020-07-01
txt: ./txt/cord-285354-bp2dozzg.txt
cache: ./cache/cord-285354-bp2dozzg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/ta.0000000000002838
doi: 10.1097/ta.0000000000002838
abstract: nan
summary:
  1097 W e read with interest the article "COVID-19 outbreak in Northern Italy: Viewpoint of the Milan area surgical community," which reported the pandemic surge response of our colleagues within tertiary hospitals in Lombardy. As surgeons operating in spoke hospitals, we have paved through the pandemic in an unusual and unexpected way, many of us having to turn from surgical specialists into coronavirus disease (COVID) ward doctors. Nonetheless, being a surgeon used to emergencies in peripheral hospitals was a valuable resource during the COVID mass casualty incident because of our commitment to patients and acute care background. 1 Our daily schedule changed dramatically when we were asked to cancel elective surgery to increase the hospital capacity in mechanical respirators and intensive care personnel for COVID-19 patients. Surgery in the coronavirus disease 2019 phase 2 Italian scenario:Lessons learned in northern Italy spoke hospitals W e thank Dr. Costanzi and colleagues for their appreciation and interesting insights about our work.

title:
  In response to: Surgery in the COVID-19 phase 2 Italian scenario: Lessons learned in Northern Italy spoke hospitals


id: cord-285774-hvuzxlna
author: Danion, J.
date: 2020-07-03
txt: ./txt/cord-285774-hvuzxlna.txt
cache: ./cache/cord-285774-hvuzxlna.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11695-020-04829-1
doi: 10.1007/s11695-020-04829-1
summary:
  title: Bariatric Surgical Simulation: Evaluation in a Pilot Study of SimLife, a New Dynamic Simulated Body Model The aim of the work was to assess the realism of a new cadaveric model for simulated bariatric surgery (sleeve and Roux in Y gastric bypass). CONCLUSION: The use of the SimLife model allows proposing a very realistic surgical simulation model to realistically train and objectively evaluate the performance of young surgeons. Surgical simulation provides the opportunity for supervised directed learning of trainees, allowing full mastering of technical skill and increasing performances before actual practice on patients [6] [7] [8] [9] . For this purpose, we developed the SimLife model, based on fresh human body given to science, dynamized by pulsatile vascularization with simulated blood, warmed to 37°C and ventilation [10, 11] . High case volumes and surgical fellowships are associated with improved outcomes for bariatric surgery patients: a justification of current credentialing initiatives for practice and training

title:
  Bariatric Surgical Simulation: Evaluation in a Pilot Study of SimLife, a New Dynamic Simulated Body Model

abstract:
  BACKGROUND: The demand for bariatric surgery is high and so is the need for training future bariatric surgeons. Bariatric surgery, as a technically demanding surgery, imposes a learning curve that may initially induce higher morbidity. In order to limit the clinical impact of this learning curve, a simulation preclinical training can be offered. The aim of the work was to assess the realism of a new cadaveric model for simulated bariatric surgery (sleeve and Roux in Y gastric bypass). AIM: A face validation study of SimLife, a new dynamic cadaveric model of simulated body for acquiring operative skills by simulation. The objectives of this study are first of all to measure the realism of this model, the satisfaction of learners, and finally the ability of this model to facilitate a learning process. METHODS: SimLife technology is based on a fresh body (frozen/thawed) given to science associated to a patented technical module, which can provide pulsatile vascularization with simulated blood heated to 37 °C and ventilation. RESULTS: Twenty-four residents and chief residents from 3 French University Digestive Surgery Departments were enrolled in this study. Based on their evaluation, the overall satisfaction of the cadaveric model was rated as 8.52, realism as 8.91, anatomic correspondence as 8.64, and the model’s ability to be learning tool as 8.78. CONCLUSION: The use of the SimLife model allows proposing a very realistic surgical simulation model to realistically train and objectively evaluate the performance of young surgeons.


id: cord-286523-4ip8er0h
author: Grippaudo, Francesca Romana
date: 2020-08-26
txt: ./txt/cord-286523-4ip8er0h.txt
cache: ./cache/cord-286523-4ip8er0h.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s00238-020-01725-w
doi: 10.1007/s00238-020-01725-w
summary:
  Most of the Italian plastic surgery wards faced a reduction in beds and theatres to enable hospitals to free up healthcare staff to provide medical care for patients in other areas, given the need for a change in work organization to comply with limited outpatient clinic activities and reduced theatre availability for all hospitalization typologies and to cope with new pre-hospitalization modalities to screen up COVID-19 positive patients among the ones scheduled for surgery. Are you in contact with anyone who has been confirmed to be COVID-19 posiƟve, or that are in quaranƟne for exposure to Study data shows the effects of the consequence of cancellation of plastic surgery elective surgeries in both hospitals during the lockdown, when the operating theatre was available only for such urgent procedures as melanoma or melanoma and SLNB removal or for post-traumatic reconstruction in PU1.

title:
  The impact of COVID-19 in plastic surgery departments: a comparative retrospective study in a COVID-19 and in a non-COVID-19 hospital

abstract:
  BACKGROUND: COVID-19 is a new human-infecting coronavirus for which the World Health Organization declared a global pandemic. The first Italian cases occurred in February 2020: since then, there has been an exponential increase in new cases, hospitalizations and intensive care assistance demand. This new and sudden scenario led to a forced National Health System reorganization and review of welfare priorities. The aim of this study is to evaluate the effects of this pandemic on ordinary activities in two plastic surgery divisions in Rome, hosted in a COVID-19 and a non-COVID-19 hospital. METHODS: The data of this comparative retrospective study was collected between 9 March and 9 April 2019 and the same period of 2020 from two plastic surgery units, one in a COVID-19 hospital and second in a non-COVID-19 hospital in Rome, Italy. The 2019–2020 data of the two hospitals was compared regarding the number of surgeries, post-operative dressings and first consultations performed. RESULTS: Both units sustained a decrease in workload due to lockdown effects. Statistically significant differences for day surgery procedures (p value = 0.0047) and first consultations (p value < 0.0001) were found between the COVID-19 and non-COVID-19 institutes, with a drastic trend limiting non-urgent access to COVID-19 hospitals. CONCLUSIONS: The long-term effects of healthcare reshuffling in the “COVID-19 era” imply a delay in the diagnosis and treatment of skin cancer and cancellation of many reconstructive procedures. These findings pose a question on the future consequences of a long-term limitation in plastic surgery healthcare. Level of evidence: Level III, risk/prognostic study.


id: cord-286646-d3x0rekw
title: Academic global surgery and COVID-19: Turning impediments into opportunities
author: Martin, Allison N.
date: 2020-05-14
txt: ./txt/cord-286646-d3x0rekw.txt
cache: ./cache/cord-286646-d3x0rekw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32418632/
doi: 10.1016/j.amjsurg.2020.05.022
abstract: nan
summary:
  As the COVID-19 pandemic has shut borders and economies around the globe, many will look internally to protect our own, and the support of global surgery programs that rely on international travel exchanges may be in jeopardy. Yet, a pandemic also highlights the true interdependence of health around the world, and the impediments to sustaining academic global surgery programs are perhaps also opportunities to better develop and maintain programs that incorporate the competencies of global surgery into a future of collaborative surgical education and innovation. The current global public health crisis illustrates resource constraints, health inequities and structural disparities in healthcare systems worldwidedleaders of tomorrow need a global view, and so it is particularly important to incorporate an academic global surgery curriculum that includes principles of ethics, health economics, disparities, and varying clinical pathologies.


id: cord-287376-wxldnlih
author: Krüger, Colin M.
date: 2020-08-03
txt: ./txt/cord-287376-wxldnlih.txt
cache: ./cache/cord-287376-wxldnlih.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3205/dgkh000354
doi: 10.3205/dgkh000354
summary:
  Finally, the choice of surgical method, whether open surgery or minimally invasive procedures, is critical in determining how many colleagues are exposed to the risk of infection from COVID-19 patients, sometimes for hours. Here, robot-assisted surgery can comply with the pandemic''s requirement to "keep your distance" in a unique way, since the surgeon can operate at virtually any distance from the surgical site, at least with regard to aerosol formation and exposure. There were two central factors in the German hospital landscape that led to the restrictions described below: First, the call by the German Federal Ministry of Health to substantially increase the number of intensive care beds which would allow invasive ventilation of patients by temporarily postponing elective procedures; and second, the shortage of personal protective equipment (PPE), which is mainly produced in China, that accompanied the beginning of the pandemic.

title:
  Can surgery follow the dictates of the pandemic “keep your distance”? Requirements with COVID-19 for hygiene, resources and the team

abstract:
  Since the beginning of the pandemic, there have been restrictions in the daily care of surgical patients – both elective and emergency. Readying supply capacities and establishing isolation areas and areas for suspected cases in the clinics have led to keeping beds free for treating (suspected) COVID-19 cases. It was therefore necessary to temporarily postpone elective surgery. Now, elective care can be gradually resumed with the second phase of the pandemic in Germany. However, it remains the order of the day to adapt pre-, intra- and post-operative procedures to the new COVID-19 conditions while maintaining specialized hygiene measures. This concerns the correct procedure for the use of personal protective materials as well as process adjustment for parallel treatment of positive and negative patients in the central OR, and handling of aerosols in the operating theater, operating room, and surgical site under consideration of staff and patient protection. Although dealing with surgical smoke in the operating theater has long been criticized, COVID-19 is forcing a renaissance in this area. Finally, the choice of surgical method, whether open surgery or minimally invasive procedures, is critical in determining how many colleagues are exposed to the risk of infection from COVID-19 patients, sometimes for hours. Here, robot-assisted surgery can comply with the pandemic’s requirement to “keep your distance” in a unique way, since the surgeon can operate at virtually any distance from the surgical site, at least with regard to aerosol formation and exposure.


id: cord-290771-18dj37dj
author: Tzeng, Ching-Wei D.
date: 2020-05-18
txt: ./txt/cord-290771-18dj37dj.txt
cache: ./cache/cord-290771-18dj37dj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/sla.0000000000004092
doi: 10.1097/sla.0000000000004092
summary:
  CONCLUSIONS: Cancer surgeons should continue to use their oncologic knowledge to determine the window of opportunity for each surgical procedure, based on tumor biology, preoperative treatment sequencing, and response to systemic therapy, to safely guide patients through this cautious recovery phase. Total surgical case volume by week during early COVID-19 response, in which MD Anderson Cancer Center implemented goals to create a ''''moat'''' around hospitalized patients, to reduce workforce and visitor traffic, and to limit ''''elective'''' cases. Because the Department of Surgical Oncology and MD Anderson Cancer Center have traditionally favored neoadjuvant therapy for many solid tumors, we strategically initiated or continued this treatment sequencing when possible to postpone surgery to beyond the late April peak of COVID-19 incidence in the Houston area.

title:
  Cancer Surgery Scheduling During and After the COVID-19 First Wave: The MD Anderson Cancer Center Experience

abstract:
  OBJECTIVE: To summarize the multi-specialty strategy and initial guidelines of a Case Review Committee in triaging oncologic surgery procedures in a large Comprehensive Cancer Center and to outline current steps moving forward after the initial wave. SUMMARY OF BACKGROUND DATA: The impetus for strategic rescheduling of operations is multifactorial and includes our societal responsibility to minimize COVID-19 exposure risk and propagation among patients, the healthcare workforce, and our community at large. Strategic rescheduling is also driven by the need to preserve limited resources. As many states have already or are considering to re-open and relax stay-at-home orders, there remains a continued need for careful surgical scheduling because we must face the reality that we will need to co-exist with COVID-19 for months, if not years. METHODS: The quality officers, chairs, and leadership of the 9 surgical departments in our Division of Surgery provide specialty-specific approaches to appropriately triage patients. RESULTS: We present the strategic approach for surgical rescheduling during and immediately after the COVID-19 first wave for the 9 departments in the Division of Surgery at The University of Texas MD Anderson Cancer Center in Houston, Texas. CONCLUSIONS: Cancer surgeons should continue to use their oncologic knowledge to determine the window of opportunity for each surgical procedure, based on tumor biology, preoperative treatment sequencing, and response to systemic therapy, to safely guide patients through this cautious recovery phase.


id: cord-293378-bi3lcj09
title: Patient Counseling in Plastic Surgery during Coronavirus Disease 2019
author: Teven, Chad M.
date: 2020-05-13
txt: ./txt/cord-293378-bi3lcj09.txt
cache: ./cache/cord-293378-bi3lcj09.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/gox.0000000000002924
doi: 10.1097/gox.0000000000002924
abstract: nan
summary:
  1 In response, hospitals have implemented significant changes to normal operating procedures to address anticipated needs of infected patients. It is, therefore, critical that both surgeons and patients understand additional risks present in the setting of the COVID-19 pandemic. First, there is a lack of evidence demonstrating how infected patients tolerate routine procedures, including physiologic response to surgery and anesthesia. First, there appears to be an increased risk of thromboembolic complications in COVID-19-positive patients. Due to unforeseen issues related to the pandemic, patients may experience atypically long delays to the second procedure. For example, evidence regarding the safety of delaying versus performing nonelective, nonemergent surgery (eg, skin cancer resection) in patients at risk for severe COVID-19 infection (eg, elderly and/or comorbidities) is limited. First, during the informed consent process, in addition to case-specific risks, benefits, and alternatives, implications of surgery during the pandemic must be discussed and documented accordingly.


id: cord-294849-qgr0e0gt
title: Elective surgery in the time of COVID-19
author: Diaz, Adrian
date: 2020-04-16
txt: ./txt/cord-294849-qgr0e0gt.txt
cache: ./cache/cord-294849-qgr0e0gt.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S000296102030218X
doi: 10.1016/j.amjsurg.2020.04.014
summary:
  The COVID-19 pandemic has placed a significant strain on the United States health care system, and frontline healthcare workers are rapidly altering their professional responsibilities to help meet hospital needs. The SARS-CoV-2 pandemic has placed a significant strain on the United States health care system, and frontline healthcare workers are rapidly altering their professional responsibilities to help meet hospital needs. In an effort to decrease disease transmission and conserve personal protective equipment (PPE), and as a result of widespread recommendations, surgeons have witnessed one of the most dramatic changes in their practices with rapidly decreasing numbers of elective surgeries. However, with so many federal and state orders, along with numerous societal recommendations, surgeons and hospital leadership are left with little guidance on how to interpret quickly evolving and sometimes conflicting information. 5 In an effort to help clarify the ambiguity surrounding federal and state guidelines relative to elective surgery, several professional societies have put out their own guidelines, often providing disease specific guidance.

abstract:
  The COVID-19 pandemic has placed a significant strain on the United States health care system, and frontline healthcare workers are rapidly altering their professional responsibilities to help meet hospital needs. In an effort to decrease disease transmission and conserve personal protective equipment (PPE), surgeons have witnessed one of the most dramatic changes in their practices with rapidly decreasing numbers of elective surgeries.


id: cord-295216-eff02z0i
author: Ahluwalia, Ranbir
date: 2020-05-20
txt: ./txt/cord-295216-eff02z0i.txt
cache: ./cache/cord-295216-eff02z0i.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s00381-020-04671-x
doi: 10.1007/s00381-020-04671-x
summary:
  While some recommendations apply to neurosurgery, particularly endoscopic sinonasal and skull base recommendations [2] , no manuscripts exist to systematically stratify risk associated with delay in common pediatric neurosurgical procedures. Urgent cases that present an immediate threat to the patient''s life or neurologic well-being (e.g., shunt malfunction, acute hematoma evacuation, tumor with hydrocephalus, empyema, spinal cord compression) are straightforward and undergo prompt surgical intervention. [27] of the membership of the American Society of Pediatric Neurosurgery (ASPN) demonstrated a strong preference for using presence of a syrinx regardless of symptoms in the setting of Chiari I malformation as a threshold for surgery [27] . In a cohort of 35 patients with total obstetric brachial palsy injury, younger age at the time of surgery correlated with better functional recovery (r = − 0.356, p = 0.049), particularly with finger and thumb flexion [59] . Patients with Chiari malformation type I presenting with acute neurological deficits: case series

title:
  The impact of imposed delay in elective pediatric neurosurgery: an informed hierarchy of need in the time of mass casualty crisis

abstract:
  SARS-CoV-2 COVID-19, coronavirus, has created unique challenges for the medical community after national guidelines called for the cancellation of all elective surgery. While there are clear cases of elective surgery (benign cranial cosmetic defect) and emergency surgery (hemorrhage, fracture, trauma, etc.), there is an unchartered middle ground in pediatric neurosurgery. Children, unlike adults, have dynamic anatomy and are still developing neural networks. Delaying seemingly elective surgery can affect a child’s already vulnerable health state by further impacting their neurocognitive development, neurologic functioning, and potential long-term health states. The purpose of this paper is to demonstrate that “elective” pediatric neurosurgery should be risk-stratified, and multi-institutional informed guidelines established.


id: cord-297362-mhtvrn0c
title: Practice Patterns of Colorectal Surgery During the COVID-19 Pandemic
author: Wu, Xian-rui
date: 2020-11-05
txt: ./txt/cord-297362-mhtvrn0c.txt
cache: ./cache/cord-297362-mhtvrn0c.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/dcr.0000000000001840
doi: 10.1097/dcr.0000000000001840
abstract: nan
summary:
  L., R.P.K.) mainly consisted of 4 domains: surgeon''s expertise and setting, practice patterns of colorectal surgery, factors associated with decision making for colorectal surgery, and safety and protection concerns of patients and health care providers. Colorectal cancer was the main indication for elective or emergent colorectal surgery during the pandemic as reported by 237 (65.3%) surgeons. 10 Consistent with this reality, this study showed that the percentage of surgeons who operated on at least 7 cases per week previous to the pandemic dropped significantly after the COVID-19 pandemic began, with emergent colorectal surgeries being less likely to be affected than elective cases. 11 This fact was reflected by the results of our survey which demonstrated that most surgeons reported colorectal cancer as the main indication for colorectal surgery during the COVID-19 pandemic. As a result, a high percentage of participating surgeons felt that more patients could safely have had elective surgery during the COVID-19 pandemic.


id: cord-298082-zzztzi8i
author: Vannini, Francesca
date: 2020-08-07
txt: ./txt/cord-298082-zzztzi8i.txt
cache: ./cache/cord-298082-zzztzi8i.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32767087/
doi: 10.1007/s00264-020-04741-4
summary:
  In a large orthopaedic facility, such as the Rizzoli Institute, with an emergency department, the maintenance of a specific pathway is mandatory to treat potentially infected patients: trauma patients for whom surgery is mandatory, who are isolated until the swab, executed at the time of the admission, whose results are negative. Cartilage regenerative procedures and even orthobiologics were among the suspended procedures; still, a delay in treatment of arthritis-promoting lesions could result in an increased number of patients who will need joint replacement in the future, with potential long-term influence on quality of life [2] . To effectively and safely return to cartilage repair surgery, the entire course of treatment should be structured to either avoid risk of infection or make it of the lowest possible impact for the hospital itself, in order to make it feasible. Patients scheduled for a cartilage procedure should visit the outpatient clinic and undergo a nasopharyngeal swab 48 hours before hospitalization [3] .

title:
  Coronavirus disease 2019 pandemic: should we delay cartilage regenerative procedures and accept the consequences, or can we find a new normality?

abstract:
  The COVID-19 pandemic changed elective surgery routine. During the initial spread of the novel coronavirus, elective surgery has been stopped and only emergency and trauma and oncologic procedures were allowed. Following the decrease of the contagion curve, elective surgery is slowly being recovered. The hospitals should create a pre-hospitalization path to identify possible infected patient and further postpone surgery. In this setting, cartilage repair surgery should not be neglected, because this could potentially lead to an increase of patients needing major joint replacement surgery.


id: cord-303054-s1clwunc
title: Guidelines: Anaesthesia in the context of COVID-19 pandemic
author: Velly, Lionel
date: 2020-06-05
txt: ./txt/cord-303054-s1clwunc.txt
cache: ./cache/cord-303054-s1clwunc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.accpm.2020.05.012
doi: 10.1016/j.accpm.2020.05.012
summary:
  Operating theatre 12 R1.3.1 -Experts suggest that healthcare professionals involved in airway management (intubation, extubation, supraglottic airway insertion and/or removal…), or those who could be brought to do so in some given situations, wear a fit tested respirator mask (Respirator N95 or FFP2 standard, or equivalent) in addition to a disposable face shield or at least, in the absence of the latter, safety goggles, regardless of the patient''s COVID-19 status (Table 1) The presence of major (i.e., very frequent or relatively characteristic) and/or minor (i.e. more inconsistent and/or less specific) symptoms allows to orient the preoperative COVID-19 status assessment, and then to estimate the benefit/risk balance of maintaining or postponing the surgery, taking into account the risk of contamination of health personnel and others patients within the care structure.

abstract:
  ABSTRACT Objectives: The world is currently facing an unprecedented healthcare crisis caused by COVID-19 pandemic. The objective of these guidelines is to produce a framework to facilitate the partial and gradual resumption of intervention activity in the context of the COVID-19 pandemic. Methods: The group has endeavoured to produce a minimum number of recommendations to highlight the strengths to be retained in the 7 predefined areas: (1) Protection of staff and patients; (2) Benefit/Risk and Patient Information; (3) Pre-operative assessment and decision on intervention; (4) Modalities of the pre-anaesthesia consultation; (5) Specificity of anaesthesia and analgesia; (6) Dedicated circuits and (7) Containment Exit Type of Interventions. Results: The SFAR Guideline panel provides 51 statements on anaesthesia management in the context of COVID-19 pandemic. After one round of discussion and various amendments, a strong agreement was reached for 100% of the recommendations and algorithms. Conclusion: We present suggestions for how the risk of transmission by and to anaesthetists can be minimised and how personal protective equipment policies relate to COVID-19 pandemic context


id: cord-303600-96vtj89w
title: Elective Gastrointestinal Surgery in COVID Times
author: Kapoor, Deeksha
date: 2020-10-22
txt: ./txt/cord-303600-96vtj89w.txt
cache: ./cache/cord-303600-96vtj89w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s12262-020-02642-9
doi: 10.1007/s12262-020-02642-9
summary:
  This led to the cancellation and delay in elective surgical cases which can have far-reaching consequences This study reports our experience of elective gastro-intestinal surgical procedures during the COVID pandemic, after instating preventive strategies and screening protocols to prevent the transmission of COVID infection. With preventive and screening strategies and proper patient selection, it is possible to deliver safe GI surgical services during the COVID pandemic, without increasing the risk for major postoperative complications. None of the surgical patients developed COVID-related symptoms in the postoperative period or required testing while in the hospital. Our experience taught us that there are three main challenges in surgery during the COVID pandemic, namely, how to select patients for elective surgical procedures; modifications, if any, of the existing treatment and surgical protocols; and ensuring the safety of patients and the healthcare personnel involved.

abstract:
  With the COVID pandemic claiming deaths the world over, the healthcare systems were overburdened. This led to the cancellation and delay in elective surgical cases which can have far-reaching consequences This study reports our experience of elective gastro-intestinal surgical procedures during the COVID pandemic, after instating preventive strategies and screening protocols to prevent the transmission of COVID infection. This is a case series analysis of elective gastro-intestinal surgical procedures performed from March 24, 2020, to July 31, 2020. During this period, 314 gastro-intestinal surgical procedures were performed; of which, 45% were for malignancies. The median age of patients was 54 years (range 8 to 94 years). Laparoscopy was used in 43% cases. Major postoperative complications (Clavien-Dindo grade 3 and above) were witnessed in 3.5% (11/314) patients, with no statistically significant difference when compared with the rate of major complications last year (45/914, 4.9% vs 11/314, 3.5%, p = 0.3). The 30-day mortality rate was 1% (n = 3). No patient developed COVID in the postoperative period. With preventive and screening strategies and proper patient selection, it is possible to deliver safe GI surgical services during the COVID pandemic, without increasing the risk for major postoperative complications.


id: cord-303631-u0rzxw7o
author: Hart, Andrew
date: 2020-06-14
txt: ./txt/cord-303631-u0rzxw7o.txt
cache: ./cache/cord-303631-u0rzxw7o.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.bjps.2020.05.082
doi: 10.1016/j.bjps.2020.05.082
abstract: nan
summary:
  Considerable supportive evidence exists for the positive impact of plastic and reconstructive surgery upon quality of life, patient reported outcomes, return to work, and longterm healthcare costs, but to most effectively advocate Plastic surgery to policy makers focused upon the risks and resource requirements of COVID-19, more, scientifically robust, data is urgently needed. The undoubted benefit of immediate reconstruction for a sizeable cohort of women is being considered against the greater apparent safety and lesser shortterm resource requirement of mastectomy and delayed reconstruction, and guidance from the Association of Breast Surgery (U.K.) is under review. It will be specifically addressed in the next issue, but the solution may be to develop capacity to provide equitable access to safe, effective reconstruction, with a low complication profile, in a governanced setting where the risk of operating during COVID infection can be minimised, and detailed consent provided that includes known and unknown risks, along with the implications of awaiting delayed reconstruction.

title:
  Cover Illustration: “Lockdown” mural, Bath Street, Glasgow, by the.rebel.bearUnshackling Plastic Surgery from COVID-19


id: cord-306016-2gudro8v
author: Pelt, Christopher E.
date: 2020-04-21
txt: ./txt/cord-306016-2gudro8v.txt
cache: ./cache/cord-306016-2gudro8v.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0883540320303843
doi: 10.1016/j.arth.2020.04.030
summary:
  In order to ensure and provide for adequate health care resources in terms of hospital capacity, personnel and personal protective equipment (PPE), service lines such as adult reconstruction and lower limb arthroplasty have stopped or substantially limited elective surgeries and have been forced to re-engineer care processes for a high-volume of patients. In order to 6 ensure and provide for adequate health care resources in terms of hospital capacity, personnel 7 and personal protective equipment (PPE), service lines such as adult reconstruction and lower 8 limb arthroplasty have stopped or substantially limited elective surgeries and have been forced 9 In order to ensure and provide for 26 adequate health care resources, hospital capacity, personnel and personal protective 27 equipment (PPE), service lines such as adult reconstruction and lower limb arthroplasty have 28 stopped or substantially limited elective surgeries and have been forced to re-engineer care 29 processes for a high-volume of patients.

title:
  The Rapid Response to the COVID-19 Pandemic by the Arthroplasty Divisions at Two Academic Referral Centers

abstract:
  The COVID-19 pandemic has created widespread changes across all of healthcare. The impacts on the delivery of orthopaedic services has been challenged as a result. In order to ensure and provide for adequate health care resources in terms of hospital capacity, personnel and personal protective equipment (PPE), service lines such as adult reconstruction and lower limb arthroplasty have stopped or substantially limited elective surgeries and have been forced to re-engineer care processes for a high-volume of patients. Herein, we summarize the similar approaches by two arthroplasty divisions in high volume academic referral centers in 1) the cessation of elective surgeries, 2) workforce restructuring, 3) phased delivery of outpatient and inpatient care, and 4) educational restructuring.


id: cord-306999-bedygxjs
author: Kurihara, Hayato
date: 2020-07-01
txt: ./txt/cord-306999-bedygxjs.txt
cache: ./cache/cord-306999-bedygxjs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33009203/
doi: 10.1097/ta.0000000000002837
abstract: nan
summary:
  • We continue, during this pandemic event, to face different surgical scenarios, emergent, urgent, and elective (particularly cancer related), and we continue to use laparoscopy (in coronavirus disease patients too) when the laparoscopic technique is recommended and widely recognized. Despite HIVand HBV being blood-borne viruses, laparoscopic surgery is being performed in HIV and HBV patients for many years, and no clear demonstration is available of viral transmission through the pneumoperitoneum or surgical smoke. For these reasons, we do not believe that results from the available literature can be extrapolated to the COVID-19 pandemic as to justify the current too restrictive guidelines on laparoscopic surgery against the evident and well-known and evidence-based advantages of laparoscopy with respect to the open approach in many fields of surgery. 1 At the end of their letter, the authors point out that "resources and expertise are widely available" during coronavirus disease 2019 (COVID-19) outbreak and a restrictive use of laparoscopy would have been acceptable only in a war scenario.

title:
  Authors'' response: Surgery in the coronavirus disease 2019 phase 2 Italian scenario: Lessons learned in northern Italy spoke hospitals


id: cord-307945-wkz43axo
title: Endocrine surgery during and after the Covid-19 epidemic: Expert guidelines in France
author: Baud, Grégory
date: 2020-04-30
txt: ./txt/cord-307945-wkz43axo.txt
cache: ./cache/cord-307945-wkz43axo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32448761/
doi: 10.1016/j.jviscsurg.2020.04.018
summary:
  Guidelines drafted by an expert group led by the French-speaking Association of Endocrine Surgery (AFCE) propose specific surgical management principles for thyroid, parathyroid, endocrine pancreas and adrenal surgery during and after the Covid-19 epidemic. Likewise, to meet their need for specific guidelines, the Frenchspeaking Association of Endocrine Surgery (AFCE) brought together a group of experts to propose principles for the surgical management of thyroid, parathyroid, endocrine pancreas and adrenal pathologies during the Covid-19 epidemic and afterwards, when surgical activity will be able to return gradually to its normal pattern. In the Covid-19 epidemic setting, its scheduling depends on the presence or absence of severe hypercalcemia, defined by a very high level of blood calcium > 3.5 mmol/l (140 mg/l) (17) , and/or the presence of clinical complications -acute pancreatitis secondary to HPT, brown tumor, calciphylaxis, fracture osteopenia, heart rhythm disorders (QT shortening on ECG, bradycardia with risk of asystole) with cardiac insufficiency (17) (18) (19) (20) .

abstract:
  Abstract The Covid-19 pandemic commands a major reorganization of the entire French healthcare system. In France, general rules have been issued nationally and implemented by each healthcare center, both public and private, throughout France. Guidelines drafted by an expert group led by the French-speaking Association of Endocrine Surgery (AFCE) propose specific surgical management principles for thyroid, parathyroid, endocrine pancreas and adrenal surgery during and after the Covid-19 epidemic.


id: cord-309629-7jtnhn65
author: Thomas, Viju
date: 2020-08-26
txt: ./txt/cord-309629-7jtnhn65.txt
cache: ./cache/cord-309629-7jtnhn65.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0301211520305509?v=s5
doi: 10.1016/j.ejogrb.2020.08.039
summary:
  We recommend, during minimal access surgeries, to use strategies to reduce production of bioaerosols (such as minimal use of energy, experienced surgeon), to reduce leakage of smoke aerosols (for example, minimizing the number of ports used and size of incisions, as well as reducing the operating pressures) and to promote safe elimination of smoke during surgery and during the ports'' closure (such as using gas filters and smoke evacuation systems). We recommend, during minimal access surgeries, to use strategies to reduce production of bioaerosols (such as minimal use of energy, experienced surgeon), to reduce leakage of smoke aerosols (for example, minimizing the number of ports used and size of incisions, as well as reducing the operating pressures) and to promote safe elimination of smoke during surgery and during the ports'' closure (such as using gas filters and smoke evacuation systems). did assess the risk of open and laparoscopic surgery to be the same provided the gas/smoke was evacuated safely and water lock filters were used or if gasless laparoscopy was performed [24] .

title:
  International society for gynecologic endoscopy (ISGE) guidelines and recommendations on gynecological endoscopy during the evolutionary phases of the SARS-CoV-2 pandemic

abstract:
  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised some important interrogations on minimally invasive gynaecological surgery. The International Society of gynaecological Endoscopists (ISGE) has taken upon itself the task of providing guidance and best practice policies for all practicing gynaecological endoscopists. Factors affecting decision making processes in minimal invasive surgery (MIS) vary depending on factors such as the phase of the pandemic, policies on control and prevention, expertise and existing infrastructure. Our responsibility remains ensuring the safety of all health care providers, ancillary staff and patients during this unusual period. We reviewed the current literature related to gynecological and endoscopic surgery during the Coronavirus Disease 19 (COVID-19) crisis. Regarding elective surgery, universal testing for SARS-CoV-2 infection should be carried out wherever possible 40 h prior to surgery. In case of confirmed positive case of SARS-CoV-2, surgery should be delayed. Priority should be given to relatively urgent cases such as malignancies. ISGE supports medical optimization and delaying surgery for benign non-life-threatening surgeries. When possible, we recommend to perform cases by laparoscopy and to allow early discharges. Any procedure with risk of bowel involvement should be performed by open surgery as studies have found a high amount of viral RNA (ribonucleic acid) in stool. Regarding urgent surgery, each unit should create a risk assessment flow chart based on capacity. Patients should be screened for symptoms and symptomatic patients must be tested. In the event that a confirmed case of SARS-CoV-2 is found, every attempt should be made to optimize medical management and defer surgery until the patient has recovered and only emergency or life-threatening surgery should be performed in these cases. We recommend to avoid intubation and ventilation in SARS-CoV-2 positive patients and if at all possible local or regional anesthesia should be utilized. Patients who screen or test negative may have general anesthesia and laparoscopic surgery while strict protocols of infection control are upheld. Surgery in screen-positive as well as SARS-CoV-2 positive patients that cannot be safely postponed should be undertaken with full PPE with ensuring that only essential personnel are exposed. If available, negative pressure theatres should be used for patients who are positive or screen high risk. During open and vaginal procedures, suction can be used to minimize droplet and bioaerosol spread. In a patient who screens low risk or tests negative, although carrier and false negatives cannot be excluded, laparoscopy should be strongly considered. We recommend, during minimal access surgeries, to use strategies to reduce production of bioaerosols (such as minimal use of energy, experienced surgeon), to reduce leakage of smoke aerosols (for example, minimizing the number of ports used and size of incisions, as well as reducing the operating pressures) and to promote safe elimination of smoke during surgery and during the ports’ closure (such as using gas filters and smoke evacuation systems). During the post-peak period of pandemic, debriefing and mental health screening for staff is recommended. Psychological support should be provided as needed. In conclusion, based on the existent evidence, ISGE largely supports the current international trends favoring laparoscopy over laparotomy on a case by case risk evaluation basis, recognizing the different levels of skill and access to minimally invasive procedures across various countries.


id: cord-315297-o8mwmjql
title: COVID-19: Crisis Management in Congenital Heart Surgery
author: Stephens, Elizabeth H.
date: 2020-04-14
txt: ./txt/cord-315297-o8mwmjql.txt
cache: ./cache/cord-315297-o8mwmjql.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32302660/
doi: 10.1016/j.athoracsur.2020.04.001
abstract: nan
summary:
  This document is not meant to be a guideline but is designed to provide guidance for decision-making as we face unparalleled challenges related to congenital cardiac surgery care during this pandemic. Many factors pertaining to an individual case must be weighed, including: 1) resource-utilization, such as anticipated ventilator duration, intensive care unit stay, blood product usage, and other supplies that are or may become limited, 2) clinical status of the patient and risk of delaying surgery, 3) risk of exposure for the patient, family, and healthcare staff, and 4) co-morbidities and complexity of the procedure with implications on the usage of hospital resources, 5) in teaching hospitals, training may have to be curtailed and the most experienced surgeons used liberally, and 6) the safety of the patient''s social and clinical situation if surgery is delayed. Institutions may re-deploy members of the congenital cardiac surgery team to other patient-care settings, further depleting resources and also increasing exposure.


id: cord-317468-pnxni1x5
author: Louie, Philip K.
date: 2020-09-15
txt: ./txt/cord-317468-pnxni1x5.txt
cache: ./cache/cord-317468-pnxni1x5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11420-020-09797-x
doi: 10.1007/s11420-020-09797-x
summary:
  The purpose of this study was to describe the peri-operative outcomes of patients undergoing spine surgery for spine pathology during the heights of the COVID-19 pandemic in New York City, including particular attention to the development of SARS-CoV-2 symptoms, post-operative complications, and patient monitoring following hospital discharge during the early post-operative period. The surgical dates also encompass a period of time in which the institution (1) followed state directives to suspend elective surgery and instead utilize strict criteria to define essential surgical cases (Table 1) , (2) dispensed personal protective equipment to medical personnel, (3) selectively performed post-admission SARS-CoV-2 testing (Cepheid Xpert Xpress SARS-CoV-2 RT-PCR, Sunnyvale, CA, USA) following patient assessment by a multidisciplinary team, (4) initiated a telehealth service for post-operative follow-up, and (5) began a progressively intensive patient screening process (Fig. 1) .

title:
  Early Peri-operative Outcomes Were Unchanged in Patients Undergoing Spine Surgery During the COVID-19 Pandemic in New York City

abstract:
  BACKGROUND: Healthcare resources have been greatly limited by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic halting non-essential surgical cases without clear service expansion protocols. QUESTIONS/PURPOSES: We sought to compare the peri-operative outcomes of patients undergoing spine surgery during the SARS-CoV-2 pandemic to a matched cohort prior to the pandemic. METHODS: We identified a consecutive sample of 127 adult patients undergoing spine surgery between March 9, 2020, and April 10, 2020, corresponding with the state of emergency declared in New York and the latest possible time for 1-month surgical follow-up. The study group was matched one-to-one based on age, gender, and body mass index with eligible control patients who underwent similar spine procedures prior to the SARS-CoV-2 outbreak. Surgeries performed for infectious or oncologic indications were excluded. Intra- and post-operative complication rates, re-operations, hospital length of stay, re-admissions, post-operative visit format, development of post-operative fever and/or respiratory symptoms, and SAR-CoV2 testing. RESULTS: A total of 254 patients (127 SARS-CoV-2 pandemic, 127 matched controls) were included. One hundred fifty-eight were male (62%), and 96 were female (38%). The mean age in the pandemic group was 59.8 ± 13.4 years; that of the matched controls was 60.3 ± 12.3. All patients underwent general anesthesia and did not require re-intubation. There were no significant differences in 1-month post-operative complication rates (16.5% pandemic vs. 12.6% control). There was one death in the pandemic group. No patients tested positive for the virus. CONCLUSION: This study represents the first report of post-operative outcomes in a large group of spine surgical patients in an area heavily affected by the SARS-CoV-2 pandemic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11420-020-09797-x) contains supplementary material, which is available to authorized users.


id: cord-320877-1i0hzfjk
title: Gynecological laparoscopic surgery in the shade of COVID-19 pandemic
author: KIYKAÇ ALTINBAŞ, Şadıman
date: 2020-06-23
txt: ./txt/cord-320877-1i0hzfjk.txt
cache: ./cache/cord-320877-1i0hzfjk.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3906/sag-2004-272
doi: 10.3906/sag-2004-272
summary:
  Non-urgent elective surgeries have been cancelled or postponed to free up beds for coronavirus critically ill patients, to allow the best use of medical resources for both the patients and the health care providers, and to reduce the contamination risk of healthy people. Although elective surgeries are limited during the COVID-19 pandemic, situations requiring an urgent gynaecological or obstetric surgical approach must still be performed. Although elective surgeries are limited during the COVID-19 pandemic, situations requiring an urgent gynaecological or obstetric surgical approach must still be performed. The routes chosen to perform the surgery either by open or by minimally invasive (laparoscopy, robotics or vaginally) techniques, it is vital to follow patient management algorithms prepared within the evidence during COVID-19 pandemic. When aerosol-generating procedures are performed, and until air exchanges have reduced the virus after the procedure, airborne precaution PPE is recommended and should be worn by all surgical staff within the OR during all operations, whether by laparoscopy or laparotomy [5, 15] .

abstract:
  A global public health problem with a high rate spread and transmission, Coronavirus outbreak has become the most talked-about matter throughout the world. We are severely affected by the nations with vast numbers of deaths; it was hard to predict such a colossal pandemic with terrifying consequences. Elective surgeries are limited, but situations requiring an urgent gynaecological or obstetric surgical approach must still be performed during the COVID-19 pandemic. Concerns regarding surgical safety and the risk of viral transmission during surgery are of great importance. In this review, we aimed to summarize the concepts related to laparoscopic gynecological surgery during COVID-19 pandemic in the light of current literature.


id: cord-321142-807sfjiv
title: Impacts of elective surgical cancellations and postponements in Canada
author: Sommer, Jordana L.
date: 2020-10-21
txt: ./txt/cord-321142-807sfjiv.txt
cache: ./cache/cord-321142-807sfjiv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33085061/
doi: 10.1007/s12630-020-01824-z
summary:
  Multivariable logistic regressions examined associations between past-year non-emergency surgical cancellations/postponements and perceived impacts of waiting for surgery (e.g., worry/stress/anxiety, pain, loss of work, loss of income, deterioration of health, relationships suffered). Multivariable logistic regressions examined associations between past-year nonemergency surgical cancellations/postponements and perceived impacts of waiting for surgery (e.g., worry/ stress/anxiety, pain, loss of work, loss of income, deterioration of health, relationships suffered). Considering the limited research in this area, the current study is an exploratory epidemiological examination of relationships between surgical cancellations and postponements with perceived impacts of waiting for elective surgery (e.g., worry/stress/anxiety, pain, deterioration of health, increased dependence on relatives/friends, and loss of work). To our knowledge, this is the first study to examine patientreported health, social, and functional impacts of waiting for surgery associated with non-emergent surgical cancellations and postponements, using population-based data.

abstract:
  PURPOSE: Worldwide, patients experience difficulties accessing elective surgical care. This study examined the perceived health, social, and functional impacts of elective surgical cancellations and postponements in Canada. METHODS: We analyzed a subset of aggregate data from the Canadian Community Health Survey (CCHS) annual components from 2005 to 2014. Multivariable logistic regressions examined associations between past-year non-emergency surgical cancellations/postponements and perceived impacts of waiting for surgery (e.g., worry/stress/anxiety, pain, loss of work, loss of income, deterioration of health, relationships suffered). RESULTS: Among those who experienced a cancellation or postponement of a past-year non-emergency surgery (weighted n = 256,836; 11.8%), 23.5% (weighted n = 60,345) indicated their life was affected by waiting for surgery. After adjusting for type of surgery, year, and sociodemographics, those who experienced a surgical cancellation or postponement had increased odds of reporting their life was affected by waiting for surgery (adjusted odds ratio [aOR], 2.67; 99% confidence interval [CI], 1.41 to 5.1); in particular, they reported greater deterioration of their health (aOR, 3.47; 99% CI, 1.05 to 11.4) and increased dependence on relatives/friends (aOR, 2.53; 99% CI, 1.01 to 6.3) than those who did not have a cancellation or postponement. CONCLUSION: Results highlight the multifaceted perceived impacts of surgical cancellations/postponements. These findings suggest there is a need for improvements in reducing elective surgical cancellations and postponements. Results may also inform the development of targeted interventions to improve patients’ health and quality of life while waiting for surgery.


id: cord-321631-ip6tt81e
title: Surgical Decision Making in the Era of COVID-19: A New Set of Rules
author: Brown, Jubilee
date: 2020-04-03
txt: ./txt/cord-321631-ip6tt81e.txt
cache: ./cache/cord-321631-ip6tt81e.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32247881/
doi: 10.1016/j.jmig.2020.04.001
abstract: nan
summary:
  As we determine how to pivot our practices in this rapidly changing environment, the issues of who should have surgery and how it should be performed have become key. Based on the suggestion that viruses can remain infectious and become dispersed in a plume of aerosolized smoke or steam, we have had to examine the available data and determine if that risk is greater with minimally invasive surgery or laparotomy [1] . In this issue, Morris et al take the stand that minimally invasive surgery provides superior patient outcomes, more rapid patient healing, and the risks to staff can be mitigated by patient triage and by modifications to operative technique [2] . No matter the route of surgery, practice universal COVID precautions without venting pneumoperitoneum into the room and suctioning the plume with a closed filtration system whether open or minimally invasive surgery is performed. Joint Statement in Minimally Invasive Gynecologic Surgery During the COVID-19


id: cord-321633-qr2w7azj
author: Yadav, Sanjay Kumar
date: 2020-09-17
txt: ./txt/cord-321633-qr2w7azj.txt
cache: ./cache/cord-321633-qr2w7azj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32958987/
doi: 10.1007/s12262-020-02596-y
summary:
  title: Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool "EMERGE" Given the importance of this subject, we recognized an overt need to evaluate these guidelines in the form of a rapid scoping review and to construct a simple quality appraisal tool which gives due weightage to their impact on surgical services from the global south and can be used to evaluate rapidly emerging guidelines. This rapid scoping review of rapidly emerging laparoscopic surgery guidelines during COVID-19 found two major research gaps: lack of systematic review of the evidence (due to the urgency of situation and fear for the safety of HCPs) during their development and insufficient weightage of their impact on surgical services from the global south. EMERGE'': Construction of a simple quality appraisal tool for rapid review of laparoscopic surgery guidelines during COVID-19 pandemic.

title:
  Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

abstract:
  The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke and laparoscopy gas has led to the formulation of many guidelines during the COVID-19 pandemic. This rapid scoping review of these guidelines was done to assess the quality of their evidence and appraise them for their impact on surgical services from the global south. A simple quality appraisal tool was constructed which can be used to evaluate rapidly emerging guidelines for evidence as well as for the needs of the global south. This rapid scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Electronic databases were searched with predefined strategy and retrieved papers were screened according to relevant criteria. A simple objective tool to assess the quality of rapidly emerging guidelines including evidence, methodology, ease, resource optimization, geography, and the economy was constructed. Twenty studies met the inclusion criteria. None of the guidelines qualified to be evidence-based clinical practice guidelines as the level of evidence was uniformly rated “low”. A newly constructed tool showed good validation, reliability, and internal consistency. This rapid scoping review found two major research gaps: lack of systematic review of evidence during their development and insufficient weightage of their impact on surgical services from the global south. These significant issues were addressed by constructing a simple and more representative tool for evaluating rapidly emerging guidelines which also gives the rightful importance of their impact on surgical services from the global south.


id: cord-323314-y3k9dntf
author: Aggarwal, Sandeep
date: 2020-08-22
txt: ./txt/cord-323314-y3k9dntf.txt
cache: ./cache/cord-323314-y3k9dntf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32829450/
doi: 10.1007/s11695-020-04940-3
summary:
  title: Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice During the COVID-19 Pandemic Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care. We produced this information sheet to provide patients undergoing bariatric surgical procedures with additional information on the risks of undergoing anaesthesia and surgery around the coronavirus (COVID-19) outbreak. Recommendations for metabolic and bariatric surgery during the COVID-19 pandemic from IFSO

title:
  Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice During the COVID-19 Pandemic

abstract:
  Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from ‘Stay at Home’ to ‘Stay Alert’ in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care.


id: cord-323592-ymvvexfi
author: Botteri, Emanuele
date: 2020-11-05
txt: ./txt/cord-323592-ymvvexfi.txt
cache: ./cache/cord-323592-ymvvexfi.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33155075/
doi: 10.1007/s00464-020-08117-y
summary:
  For elective procedures, the survey included questions on thyroid surgery, lower and upper GI surgery, proctologic surgery, adrenal gland surgery, pancreatic and hepatobiliary surgery, cholecystectomy, abdominal wall surgery and breast surgery. The reported use of HED was high both in open and minimally-invasive upper and lower GI surgery. The Executive Board of SICE promoted a web-based survey to investigate how surgeons working in general surgery units across Italy currently use HED in daily clinical practice. The link to complete the questionnaire was also always available in the area of the SICE website (https ://sicei talia .com), a website dedicated to the dissemination of updates on scientific research regarding minimallyinvasive surgery and surgical innovations, mainly visited by surgeons with a particular interest in laparoscopic and minimally-invasive techniques.

title:
  Current status on the adoption of high energy devices in Italy: An Italian Society for Endoscopic Surgery and New Technologies (SICE) national survey

abstract:
  BACKGROUND: In the past three decades, different High Energy Devices (HED) have been introduced in surgical practice to improve the efficiency of surgical procedures. HED allow vessel sealing, coagulation and transection as well as an efficient tissue dissection. This survey was designed to verify the current status on the adoption of HED in Italy. METHODS: A survey was conducted across Italian general surgery units. The questionnaire was composed of three sections (general information, elective surgery, emergency surgery) including 44 questions. Only one member per each surgery unit was allowed to complete the questionnaire. For elective procedures, the survey included questions on thyroid surgery, lower and upper GI surgery, proctologic surgery, adrenal gland surgery, pancreatic and hepatobiliary surgery, cholecystectomy, abdominal wall surgery and breast surgery. Appendectomy, cholecystectomy for acute cholecystitis and bowel obstruction due to adhesions were considered for emergency surgery. The list of alternatives for every single question included a percentage category as follows: “ < 25%, 25–50%, 51–75% or > 75%”, both for open and minimally-invasive surgery. RESULTS: A total of 113 surgical units completed the questionnaire. The reported use of HED was high both in open and minimally-invasive upper and lower GI surgery. Similarly, HED were widely used in minimally-invasive pancreatic and adrenal surgery. The use of HED was wider in minimally-invasive hepatic and biliary tree surgery compared to open surgery, whereas the majority of the respondents reported the use of any type of HED in less than 25% of elective cholecystectomies. HED were only rarely employed also in the majority of emergency open and laparoscopic procedures, including cholecystectomy, appendectomy, and adhesiolysis. Similarly, very few respondents declared to use HED in abdominal wall surgery and proctology. The distribution of the most used type of HED varied among the different surgical interventions. US HED were mostly used in thyroid, upper GI, and adrenal surgery. A relevant use of H-US/RF devices was reported in lower GI, pancreatic, hepatobiliary and breast surgery. RF HED were the preferred choice in proctology. CONCLUSION: HED are extensively used in minimally-invasive elective surgery involving the upper and lower GI tract, liver, pancreas and adrenal gland. Nowadays, reasons for choosing a specific HED in clinical practice rely on several aspects, including surgeon’s preference, economic features, and specific drawbacks of the energy employed.


id: cord-327314-8vz9x8f1
author: Ni, Yan
date: 2020-05-15
txt: ./txt/cord-327314-8vz9x8f1.txt
cache: ./cache/cord-327314-8vz9x8f1.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0952818020307406?v=s5
doi: 10.1016/j.jclinane.2020.109871
abstract: nan
summary:
  title: Acute normovolemic hemodilution for major cancer surgeries during the COVID-19 pandemic: A beacon of hope cancer surgeries to be performed safely and at the earliest in such a situation of insufficient allogenic blood supplies. In our hospital, the surgical treatments of 22 cancer patients scheduled for major cancer surgeries were cancelled multiple times because of the shortage of allogenic blood supplies during February 2020. As shown in Because safety is a major focus of surgical and perioperative care, preoperatively acquired blood and blood products remain a routine safeguard for patients undergoing major cancer surgeries. ANH: acute normovolemic hemodilution, Hb: hemoglobin, Hct: hematocrit, iCa 2+ : ionized calcium, Lac: lactate, Plt: platelet, POD: Table 1 Baseline demographics, comorbidities, and types of surgery. Impact of acute normovolemic hemodilution on allogeneic blood transfusion during open abdominal cancer surgery: a propensity matched retrospective study The efficacy of acute normovolemic hemodilution for preventing perioperative allogeneic blood transfusion in gynecological cancer patients

title:
  Acute normovolemic hemodilution for major cancer surgeries during the COVID-19 pandemic: A beacon of hope


id: cord-332960-h0be6pr0
title: Laparoscopy in the coronavirus disease 2019 (COVID-19) era
author: Angioni, Stefano
date: 2020-05-14
txt: ./txt/cord-332960-h0be6pr0.txt
cache: ./cache/cord-332960-h0be6pr0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32435173/
doi: 10.1186/s10397-020-01070-7
summary:
  The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in China at the end of 2019 has become a pandemic infection that has now involved 200 countries with 465,915 confirmed cases and 21,031 confirmed deaths. Even if it is still unknown whether SARS-CoV-2 shares the properties of other viruses that can be found in laparoscopic surgical smoke, many scientific societies have published online their recommendations on laparoscopy during this pandemic. The screening of patients for coronavirus infection before planned surgical treatment or the postponement of surgery on suspected or documented SARS-CoV-2-positive patients until their full recovery, if there is no immediate life-threatening situation, is strongly recommended. In addition to suggestions to reduce aerosol diffusion during and immediately after laparoscopy, the AAGL provides similar advice on screening patients before surgery and suggests additional imaging evaluation (chest computed tomography) prior to any surgical procedure, based on published data on its high predictive ability for early disease [28] .

abstract:
  The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in China at the end of 2019 has become a pandemic infection that has now involved 200 countries with 465,915 confirmed cases and 21,031 confirmed deaths. Unfortunately, many data have shown that the high number of undocumented infections could have a major role in the rapid diffusion of the disease. In most of the nations involved, non-urgent, non-cancer procedures have been stopped to reallocate medical and paramedical staff to face the emergency. Moreover, concerns have been raised that minimally invasive surgery could be a procedure that carries the risk of virus diffusion in the operating theater during surgery. This paper reports clinical recommendations and scientific studies to assist clinicians in this field.


id: cord-335141-ag3j8obh
title: FFP3 reusable respirators for COVID-19; adequate and suitable in the healthcare setting
author: Higgins, G.C.
date: 2020-06-30
txt: ./txt/cord-335141-ag3j8obh.txt
cache: ./cache/cord-335141-ag3j8obh.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.bjps.2020.06.002
doi: 10.1016/j.bjps.2020.06.002
abstract: nan
summary:
  The British Association of Plastic, Reconstructive and Aesthetic Surgeons, the British Society for Surgery of the Hand and the Royal College of Surgeons of England, have all issued guidance: both encouraging patients to avoid risky pursuits, which could result in accidental injuries and to members how to prioritise and optimise services for trauma and urgent cancer work. We have adapted our Hand Trauma Service to a ''One Stop Hand Trauma and Therapy'' clinic, where patients are assessed, definitive surgery performed and offered immediate post-operative hand therapy where therapists make splint and give specialist advice on wound care and rehabilitation including an illustrated hand therapy guide. Local assessment of our practice is ongoing but we have found that this model has enabled a cohort of vulnerable plastic surgery trainees to successfully continue to work whilst reducing the risk of exposure to COVID-19 and providing gold standard care for patients.


id: cord-336438-mlgxiyur
title: Covid-19 and surgery: Challenging issues in the face of new normal – A narrative review
author: Huda, Farhanul
date: 2020-10-23
txt: ./txt/cord-336438-mlgxiyur.txt
cache: ./cache/cord-336438-mlgxiyur.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33133594/
doi: 10.1016/j.amsu.2020.10.039
summary:
  This review aims to outline the current perspectives of surgery in the COVID 19 pandemic associated with the pitfalls in implementing the emerging guidelines to continue patient care without compromising the safety, both from surgeons'' and patients'' points of view. The fight between the surgeon and the pandemic will be a dragging one since the post-pandemic efflux of the surgical patients coupled with the ''new normal'' practices to prevent COVID 19 spread requires pertinent resources, well-trained personnel, and co-operation among different departments. The global impact of the COVID 19 pandemic has challenged the healthcare system worldwide to provide quality care while restricting transmission to non-COVID 19 patients and health care workers (HCW). Since surgery exposes the healthcare team to blood and body fluids of infected patients, surgical specialties have been struggling all this while trying to strike a balance between the evolving guidelines of sick patient management who need surgical care and protecting themselves and their HCW from undue exposure.

abstract:
  This review aims to outline the current perspectives of surgery in the COVID 19 pandemic associated with the pitfalls in implementing the emerging guidelines to continue patient care without compromising the safety, both from surgeons' and patients' points of view. The fight between the surgeon and the pandemic will be a dragging one since the post-pandemic efflux of the surgical patients coupled with the ‘new normal’ practices to prevent COVID 19 spread requires pertinent resources, well-trained personnel, and co-operation among different departments. Emergency surgeries and cancer care have continued all this while, undoubtedly, with unwanted delays and distress. While we continue to prepare ourselves and work in a whole new environment, surgeons are facing the increased chances of litigations and compromised safety. We review what we have come to understand about safe surgical practices during and after the pandemic and the unanswered questions.


id: cord-336676-r8x4zhc2
title: Should WALANT surgery be included in the training curriculum?
author: Thakkar, M
date: 2020-05-26
txt: ./txt/cord-336676-r8x4zhc2.txt
cache: ./cache/cord-336676-r8x4zhc2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.bjps.2020.05.072
doi: 10.1016/j.bjps.2020.05.072
abstract: nan
summary:
  Our anaesthetic colleagues are under immense pressure and in some instances have been redeployed to other settings, limiting our ability to operate under general or regional anaesthesia. We propose that training in both wide awake local anaesthesia no tourniquet (WALANT) as well as ultrasound guided blocks should be incorporated into plastic surgery training or at the very least in to the hand surgery subspecialty curriculum to help overcome such a problem in the future. We therefore propose that WALANT should be incorporated into plastic surgery training curriculum. We recognise that it might not be an approach favoured by all once the pandemic is over however, increasing the variety of skills taught to future plastic surgeons should be encouraged. Furthermore, the Hand Diploma or subspecialty interest in hand surgery curriculum could include training on regional ultrasound guided blocks. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: The dalhousie project clinical phase


id: cord-344508-a67vsux2
title: Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement
author: Campanile, Fabio Cesare
date: 2020-06-08
txt: ./txt/cord-344508-a67vsux2.txt
cache: ./cache/cord-344508-a67vsux2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13017-020-00317-0
doi: 10.1186/s13017-020-00317-0
summary:
  Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have. The SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie), ACS-Italy Chapter (American College of Surgeons), AICO (Associazione Italiana infermieri di Camera Operatoria), CRSA (Clinical Robotic Surgery Association), SICG (Società Italiana di Chirurgia Geriatrica), SICOP (Società Italiana di Chirurgia dell''Ospedalità Privata), SPIGC (Società Polispecialistica Italiana dei Giovani Chirurghi), and the WSES (World Society of Emergency Surgery) have come out in favor of a rational analysis of the issue, especially about the choice of the surgical techniques to be implemented, preferring a "selective" approach that does not exclude the use of laparoscopy a priori but, instead, strongly considers it.

abstract:
  Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level. We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.


id: cord-345496-gdnpz6a1
title: Abdominal Wall Surgery after SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures?
author: López Cano, Manuel
date: 2020-10-19
txt: ./txt/cord-345496-gdnpz6a1.txt
cache: ./cache/cord-345496-gdnpz6a1.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S2173507720302076
doi: 10.1016/j.cireng.2020.10.013
summary:
  title: Abdominal Wall Surgery after SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures? Likewise, SARS-CoV-2 will leave its mark on the structure and organization of healthcare facilities secondary to the ''express'' change in the order and provision of care, resulting in the reorganization of hospitals and the provision of most resources for the treatment of patients affected by COVID-19. Given this situation, in our opinion, the reorganization task of returning to ''normal'' abdominal wall surgery activity can only be achieved through the cooperation of all healthcare professionals, optimizing the available resources and once again reinventing, with much effort and burnout, an insufficient and weakened healthcare model. In the same manner, patients awaiting an abdominal wall procedure (and society in general) should be aware of the problem of delayed treatment for their pathology. In short, we believe that abdominal wall surgery (at least a portion of patients requiring hospitalization) should return to surgical reorganization programs after the pandemic.

abstract:
  Pandemic by the COVID-19 has found us unprotected to provide an adequate and rapid sanitary response. The hospital network of our public health system has provided most of the resources for the treatment of patients affected by the infection. Non-essential (non-priority) surgeries have been postponed. The optimal and proportionate reestablishment of these non-priority surgeries can be a problem. This article offers a technical and non-technical view of reestablishment non-priority surgeries from the perspective of abdominal wall surgery.


id: cord-348537-rsdyiygo
author: Pignatti, Marco
date: 2020-05-15
txt: ./txt/cord-348537-rsdyiygo.txt
cache: ./cache/cord-348537-rsdyiygo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32499187/
doi: 10.1016/j.bjps.2020.05.002
summary:
  Finally we underline the importance of using telemedicine and web-based tools to transmit images of lesions that need the surgeon''s evaluation, and can be used by the patient to keep in touch with a doctor during the distressing time of delay of the expected procedure. All the patients already booked on an outpatient clinic at the time the switch from elective to urgent activity was implemented were contacted, on a daily basis, to evaluate the urgency of their case and to decide whether to cancel, postpone or maintain their appointment. However the use of internet tools for monitoring reconstructive surgery patients has been largely described 22, 23, 24 .Instant sharing of images or video calls allow plastic surgeons to make an easy consultation, filtering only clinical cases that really need to be evaluated in person for an adequate treatment.

title:
  How the COVID-19 pandemic changed the Plastic Surgery activity in a regional referral center in Northen Italy

abstract:
  The Covid 19 epidemic has modified the way that plastic surgeons can treat their patients. At our hospital all elective surgery was canceled and only the more severe cases were admitted. The outpatient department activity has been reduced also. We present the number and diagnoses of patients, treated as in- and out-patients, during seven weeks from the onset of the epidemic, comparing our activity from the lockdown of elective surgery with the numbers and diagnoses observed during the same weeks of last year. Finally we underline the importance of using telemedicine and web-based tools to transmit images of lesions that need the surgeon's evaluation, and can be used by the patient to keep in touch with a doctor during the distressing time of delay of the expected procedure.


id: cord-349206-f77ofx1w
author: Hutter, Matthew M.
date: 2020-05-26
txt: ./txt/cord-349206-f77ofx1w.txt
cache: ./cache/cord-349206-f77ofx1w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.soard.2020.05.020
doi: 10.1016/j.soard.2020.05.020
abstract: nan
summary:
  To: Insurance Company, Medical Director During these unprecedented times with the COVID-19 pandemic, it has become clear that some 10 populations are at increased risk of severe illness, complications, and death once contracting the novel coronavirus. Based on data from multiple studies that show no benefit to insurancemandated documentation of diet effort and/or weight loss prior to metabolic/bariatric surgery, as summarized by the ASMBS Clinical Issues Committee in our peer-reviewed publication from 2016 8 , we recommend immediate termination of all insurance-mandated diet and weight 30 related prerequisites for bariatric surgery including the excessive, burdensome, and potentially dangerous requirement for in-office weight documentation. Insurance-mandated preoperative counseling does not improve outcome and increases dropout rate in patients considering gastric bypass for morbid obesity Postoperative 105 outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program Insurance-mandated medical 110 weight management before bariatric surgery

title:
  Open Letter to Insurance Companies Regarding Mandatory in Office Visit Weight Documentation in an Era of COVID-19


id: cord-349740-xed4aybr
title: Recommendations of protective measures for orthopedic surgeons during COVID-19 pandemic
author: Wang, Yulong
date: 2020-06-10
txt: ./txt/cord-349740-xed4aybr.txt
cache: ./cache/cord-349740-xed4aybr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32524164/
doi: 10.1007/s00167-020-06092-4
summary:
  The appropriate protective measures for orthopedic surgeons and patients were reviewed (on-site first aid, emergency room, operating room, isolation wards, general ward, etc.) during the entire diagnosis and treatment process of traumatic patients. To avoid occupational transmission of COVID-19 to medical staff, appropriate protective measures taken by orthopedic surgeons during pandemic in different sites from pre-hospital, emergency diagnosis and treatment, emergency surgery, anesthesia, and perioperative management are of great importance. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work.

abstract:
  PURPOSE: It was the primary purpose of the present systematic review to identify the optimal protection measures during COVID-19 pandemic and provide guidance of protective measures for orthopedic surgeons. The secondary purpose was to report the protection experience of an orthopedic trauma center in Wuhan, China during the pandemic. METHODS: A systematic search of the PubMed, Cochrane, Web of Science, Google Scholar was performed for studies about COVID-19, fracture, trauma, orthopedic, healthcare workers, protection, telemedicine. The appropriate protective measures for orthopedic surgeons and patients were reviewed (on-site first aid, emergency room, operating room, isolation wards, general ward, etc.) during the entire diagnosis and treatment process of traumatic patients. RESULTS: Eighteen studies were included, and most studies (13/18) emphasized that orthopedic surgeons should pay attention to prevent cross-infection. Only four studies have reported in detail how orthopedic surgeons should be protected during surgery in the operating room. No detailed studies on multidisciplinary cooperation, strict protection, protection training, indications of emergency surgery, first aid on-site and protection in orthopedic wards were found. CONCLUSION: Strict protection at every step in the patient pathway is important to reduce the risk of cross-infection. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work. LEVEL OF EVIDENCE: IV.


id: cord-350377-vq9eblr0
author: Sukumar, Vivek
date: 2020-10-14
txt: ./txt/cord-350377-vq9eblr0.txt
cache: ./cache/cord-350377-vq9eblr0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33071520/
doi: 10.1007/s13193-020-01241-0
summary:
  There is a need to incorporate and strictly enforce various strategies such as enhanced recovery programs which have demonstrated to lower recovery time and post-operative complication rates, helping us to optimally utilize the minimum available resources without burdening the already strained health care infrastructure [3] . All patients admitted and undergoing major elective as well as emergency surgeries under the Division of Colorectal and Peritoneal Surface Oncology were included in the study. The European Society of Medical Oncology (ESMO) guidelines and American College of Surgeons (ACS) have advised to give priority to patient with cancers with the ACS suggesting surgeons to look at the Elective Surgery Acuity Scale (ESAS) from St. Louis University which include most cancers in Tier 3a and calls for non-post-ponement of surgery in these cases [6, 7] . Tackling the reduction in hospital resources towards surgical care, the department managed to operate 90 patients over a 2-month period.

title:
  Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour

abstract:
  The health services across the world have been deeply impacted by the ongoing COVID-19 pandemic which has resulted in diversion of resources to testing, isolating and treating COVID-19 patients. This meant cutting down resources and manpower away of various healthcare facilities and severely hampering the functioning of various cancer services across the world. It is however, important to understand, cancer itself is a life-threatening condition, and there is a need to continue running cancer care services, at least for those who needed the most. Various clinical societies have put forward guidelines and protocols to help continue surgical services during the pandemic. The role of minimally invasive surgery (MIS) was initially questioned at the start of the pandemic, however gradually increasing evidence favored MIS as it reduced hospital stay and complication. Enhanced recovery programs which have been introduced to various fields of surgery to improve outcomes and reduce hospital stay. It plays an essential role in times like this, where the optimal usage of minimal resources is essential. We embraced these methods to ensure safety of our patients and staff and at the same time provide the highest standards of care. Here we are presenting our experience of running a colorectal surgical unit during these difficult times with emphasis on promotion of minimally invasive surgery, at the epicenter of the pandemic in India.


id: cord-353004-ocnp758o
title: COVID-19 in the operating room: a review of evolving safety protocols
author: Prakash, Lakshmanan
date: 2020-07-20
txt: ./txt/cord-353004-ocnp758o.txt
cache: ./cache/cord-353004-ocnp758o.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13037-020-00254-6
doi: 10.1186/s13037-020-00254-6
summary:
  METHODS: A systematic review of the available literature was performed using the keyword terms "COVID-19", "Coronavirus", "surgeon", "health-care workers", "protection" and "Orthopaedic Surgery". A systematic review of the available literature was performed using the keyword terms "COVID-19", "Coronavirus", "surgeon", "health-care workers", "protection" and "Orthopaedic Surgery". Not much has been written on the risks involved, methods and precautions required for an orthopedic surgeon and his operating room personnel whilst carrying out surgical procedures within the theatre. He proposed an decision-making algorithm ( Fig. 1 ) for deciding whether and when to proceed with an elective surgery, based on surgical indications and predicted requirement of critical resources, including blood product transfusions, estimated length of hospital stay, and the possible requirement for post-operative ventilation and ICU care [14] . Surgeons and personnel not needed for intubation should remain outside the operating room until anesthesia induction and intubation are completed for patients with or suspected of having COVID-19 infection [24] .

abstract:
  BACKGROUND: The COVID-19 pandemic has already infected more than 3 million people across the world. As the healthworkers man the frontlines, the best practices model is continuously evolving as literature concerning the Coronavirus develops. METHODS: A systematic review of the available literature was performed using the keyword terms “COVID-19”, “Coronavirus”, “surgeon”, “health-care workers”, “protection” and “Orthopaedic Surgery”. All peer-reviewed articles we could find were considered. Randomized controlled trials (RCTs), prospective trials and retrospective studies, as well as reviews and case reports, were included in this systematic review. RESULTS: Even though surgical specialties including orthopedics are on the relative sidelines of the management of this pandemic but best practices models are inevitably developed for surgical specialties. The algorithm of postpone, delay, and operate only when life-threatening conditions exist is going to be useful up to a point. CONCLUSION: The surgical staff needs to keep abreast of the latest literature concerning safety measures to be taken during surgical procedures. Review articles can go some distance in helping in this educational process. This knowledge must evolve as new information comes to light.


id: cord-353587-5e0kxjlt
title: COVID-19 and cataract surgery backlog in Medicare beneficiaries
author: Aggarwal, Shruti
date: 2020-07-17
txt: ./txt/cord-353587-5e0kxjlt.txt
cache: ./cache/cord-353587-5e0kxjlt.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/j.jcrs.0000000000000337
doi: 10.1097/j.jcrs.0000000000000337
summary:
  PURPOSE: To forecast the volume of cataract surgery in Medicare beneficiaries in the United States in 2020 and to estimate the surgical backlog that may be created due to COVID-19. In this investigation, our goals were (1) to model the volume of cataract surgery in Medicare beneficiaries in 2020 in light of to estimate the surgical backlog that might have been created due to elective surgery suspension and subsequent ramp-up. It was assumed that once the elective surgical suspension period is over, there would be a ramp-up period, and the volume of cataract surgeries performed would not immediately revert back to 100% of the prepandemic forecast. Once elective surgical suspension is lifted and surgeries resume, the Monte Carlo simulation revealed that under the optimistic scenario, it would take 4 months to revert to 90% of the prepandemic forecasted volume (performing at least 280 000 cases per month).

abstract:
  PURPOSE: To forecast the volume of cataract surgery in Medicare beneficiaries in the United States in 2020 and to estimate the surgical backlog that may be created due to COVID-19. DESIGN: Epidemiologic modeling. METHODS: Baseline trends in cataract surgery among Medicare beneficiaries were assessed by querying the Medicare Part B Provider Utilization National Summary data. It was assumed that once the surgical deferment is over, there will be a ramp-up period; this was modeled using a stochastic Monte Carlo simulation. Total surgical backlog 2 years postsuspension was estimated. Sensitivity analyses were used to test model assumptions. RESULTS: Assuming cataract surgeries were to resume in May 2020, it would take 4 months under an optimistic scenario to revert to 90% of the expected pre-COVID forecasted volume. At 2-year postsuspension, the resulting backlog would be between 1.1 and 1.6 million cases. Sensitivity analyses revealed that a substantial surgical backlog would remain despite potentially lower surgical demand in the future. CONCLUSIONS: Suspension of elective cataract surgical care during the COVID-19 surge might have a lasting impact on ophthalmology and will likely result in a cataract surgical patient backlog. These data may aid physicians, payers, and policymakers in planning for postpandemic recovery.


id: cord-354593-35qkn381
author: Sii, Samantha Siaw Zhen
date: 2020-10-22
txt: ./txt/cord-354593-35qkn381.txt
cache: ./cache/cord-354593-35qkn381.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1038/s41433-020-01229-8
doi: 10.1038/s41433-020-01229-8
abstract: nan
summary:
  title: Impact of COVID-19 on cataract surgerypatients'' perceptions while waiting for cataract surgery and their willingness to attend hospital for cataract surgery during the easing of lockdown period During these unprecedented times, it is therefore important to keep patients informed, particularly about the potential risk of contracting COVID-19 infection during restoration of cataract surgery services [7] . The aim of this survey is to determine patients'' perceptions while waiting for cataract surgery during the pandemic and their willingness to have their operation following the easing of lockdown. The survey''s composite outcome measures were patients'' concern regarding cataract surgery delay, their willingness to attend hospital for cataract surgery during easing of the COVID-19 lockdown, and their maximum acceptable waiting time (MAWT) for cataract surgery [8, 9] . Patient and physician perspectives of maximum acceptable waiting times for cataract surgery Which factors influence patients'' maximum acceptable waiting time for cataract surgery?

title:
  Impact of COVID-19 on cataract surgery- patients’ perceptions while waiting for cataract surgery and their willingness to attend hospital for cataract surgery during the easing of lockdown period


