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

Abstract

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

Resumo

Estima-se que cerca de 28 milhões de cirurgias sejam postergadas ou canceladas no mundo em decorrência desta pandemia, causando atraso no diagnóstico e tratamento de mais de 2 milhões de casos oncológicos. No Brasil, tanto a ANS (Agencia Nacional de Saúde) como a ANVISA (Agencia Nacional de Vigilância Sanitária) orientaram o adiamento das cirurgias eletivas e não essenciais, tendo um impacto considerável no número de procedimentos cirúrgicos com diminuição de 33,4% neste período no Brasil. No entanto, algumas mulheres necessitam de tratamento para várias doenças ginecológicas, algumas das quais não podem ser adiadas. O objetivo deste artigo é apresentar recomendações sobre o tratamento cirúrgico durante a pandemia de COVID-19.

Keywords

COVID-19 - laparoscopy - hysteroscopy - gynecological surgery

Palavras-chave

COVID-19 - Laparoscopia - Histeroscopia - Cirurgia ginecológica

^* This text was prepared by members of the National Specialized Commission on Endometriosis, Gynecological Endoscopy and Urogynecology and Vaginal Surgery.

• References

• 1 Brindle M, Gawande A. Managing COVID-19 in surgical systems. Ann Surg 2020; ••• [ahead of print]
• 2 Lei S, Jiang F, Su W, Chen C, Chen J, Mei W. , et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine 2020; 21: 100331 . Doi: 10.1016/j.eclinm.2020.100331
• 3 Setti L, Passarini F, De Gennaro G, Barbieri P, Perrone MG, Borelli M. , et al. Airborne transmission route of COVID- 19: why 2 meters/6 feet of inter-personal distance could not be enough. Int J Environ Res Public Health 2020; 17 (08) 2932 . Doi: 10.3390/ijerph17082932
• 4 van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN. , et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382 (16) 1564-1567 . Doi: 10.1056/NEJMc2004973
• 5 Day AT, Sher DJ, Lee RC, Truelson JM, Myers LL, Sumer BD. , et al. Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks. Oral Oncol 2020; 105: 104684 . Doi: 10.1016/j.oraloncology.2020.104684
• 6 European Society for Gynaecological Endoscopy. ESGE Recommendations on Gynaecological Laparoscopic Surgery during Covid-19 Outbreak [Internet]. 2020 [cited 2020 May 04]. Available from: https://esge.org/wp-content/uploads/2020/03/Covid19StatementESGE.pdf
• 7 American Association of Gynecologic Laparoscopists. COVID-19: joint statement on minimally invasive gynecologic surgery. [Internet]. 2020 [cited 2020 May 04]. Available from: https://www.aagl.org/news/covid-19-joint-statement-on-minimally-invasive-gynecologic-surgery/
• 8 Steward JE, Kitley WR, Schmidt CM, Sundaram CP. Urologic surgery and COVID- 19: how the pandemic is changing the way we operate. J Endourol 2020; 34 (05) 541-549 . Doi: 10.1089/end.2020.0342
• 9 Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y. , et al. Antibody responses to SARS-CoV-2 in patients of novel Coronavirus Disease 2019. Clin Infect Dis 2020; Mar 28; ciaa344 . Doi: 10.1093/cid/ciaa344. [ahead of print]
• 10 Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y. , et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395 (10223): 507-513 . Doi: 10.1016/S0140-6736(20)30211-7
• 11 Radonovich Jr LJ, Simberkoff MS, Bessesen MT, Brown AC, Cummings DAT, Gaydos CA. , et al; ResPECT investigators. N95 respirators vs medical masks for preventing influenza among health care personnel: a randomized clinical trial. JAMA 2019; 322 (09) 824-833 . Doi: 10.1001/jama.2019.11645
• 12 Chiofalo B, Baiocco E, Mancini E, Vocaturo G, Cutillo G, Vincenzoni C. , et al. Practical recommendations for gynecologic surgery during the COVID-19 pandemic. Int J Gynaecol Obstet 2020; ••• [ahead of print]