[Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation].
Identifieur interne : 000097 ( Main/Exploration ); précédent : 000096; suivant : 000098[Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation].
Auteurs : J-J Tuech [France] ; A. Gangloff [France] ; F. Di Fiore [France] ; P. Michel [France] ; C. Brigand [France] ; K. Slim [France] ; M. Pocard [France] ; L. Schwarz [France]Source :
- Journal de chirurgie viscerale [ 1878-786X ] ; 2020.
Abstract
The COVID-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery. Healthcare priorities and circuits are being modified. Emergency surgery is still a priority. Functional surgery is to be deferred. Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk. The question looms large in cancer surgery - go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery. For each type of cancer - colon, pancreas, oesogastric, hepatocellular carcinoma - morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time. Strategies can be proposed based on this comparison. For colonic cancers T1-2, N0, it is advisable to defer surgery. For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait. For rectal cancers T3-4 and /or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections. Most complex surgery with high morbidity and mortality - oesogastric, hepatic or pancreatic - is most often best deferred.
DOI: 10.1016/j.jchirv.2020.03.007
PubMed: 32834885
PubMed Central: PMC7271206
Affiliations:
- France
- Alsace (région administrative), Auvergne (région administrative), Auvergne-Rhône-Alpes, Grand Est, Haute-Normandie, Région Normandie, Île-de-France
- Clermont-Ferrand, Paris, Rouen, Strasbourg
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Brigand</name><affiliation wicri:level="3"><nlm:affiliation>Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg</wicri:regionArea><placeName><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Slim, K" sort="Slim, K" uniqKey="Slim K" first="K" last="Slim">K. 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Gangloff</name><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Di Fiore, F" sort="Di Fiore, F" uniqKey="Di Fiore F" first="F" last="Di Fiore">F. Di Fiore</name><affiliation wicri:level="3"><nlm:affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Michel, P" sort="Michel, P" uniqKey="Michel P" first="P" last="Michel">P. Michel</name><affiliation wicri:level="3"><nlm:affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Brigand, C" sort="Brigand, C" uniqKey="Brigand C" first="C" last="Brigand">C. Brigand</name><affiliation wicri:level="3"><nlm:affiliation>Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg</wicri:regionArea><placeName><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Slim, K" sort="Slim, K" uniqKey="Slim K" first="K" last="Slim">K. Slim</name><affiliation wicri:level="3"><nlm:affiliation>Department of digestive surgery, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of digestive surgery, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Auvergne (région administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation></author><author><name sortKey="Pocard, M" sort="Pocard, M" uniqKey="Pocard M" first="M" last="Pocard">M. Pocard</name><affiliation wicri:level="3"><nlm:affiliation>UMR 1275 CAP Paris-Tech, université de Paris, 75010 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UMR 1275 CAP Paris-Tech, université de Paris, 75010 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Service de chirurgie digestive et cancérologique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de chirurgie digestive et cancérologique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schwarz, L" sort="Schwarz, L" uniqKey="Schwarz L" first="L" last="Schwarz">L. Schwarz</name><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Surgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Surgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal de chirurgie viscerale</title><idno type="ISSN">1878-786X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The COVID-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery. Healthcare priorities and circuits are being modified. Emergency surgery is still a priority. Functional surgery is to be deferred. Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk. The question looms large in cancer surgery - go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery. For each type of cancer - colon, pancreas, oesogastric, hepatocellular carcinoma - morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time. Strategies can be proposed based on this comparison. For colonic cancers T1-2, N0, it is advisable to defer surgery. For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait. For rectal cancers T3-4 and /or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections. Most complex surgery with high morbidity and mortality - oesogastric, hepatic or pancreatic - is most often best deferred.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32834885</PMID><DateRevised><Year>2020</Year><Month>08</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1878-786X</ISSN><JournalIssue CitedMedium="Print"><Volume>157</Volume><Issue>3</Issue><PubDate><Year>2020</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Journal de chirurgie viscerale</Title><ISOAbbreviation>J Chir Visc</ISOAbbreviation></Journal><ArticleTitle>[Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation].</ArticleTitle><Pagination><MedlinePgn>S6-S12</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jchirv.2020.03.007</ELocationID><Abstract><AbstractText>The COVID-19 pandemic is changing the organization of healthcare and has a direct impact on digestive surgery. Healthcare priorities and circuits are being modified. Emergency surgery is still a priority. Functional surgery is to be deferred. Laparoscopic surgery must follow strict rules so as not to expose healthcare professionals (HCPs) to added risk. The question looms large in cancer surgery - go ahead or defer? There is probably an added risk due to the pandemic that must be balanced against the risk incurred by deferring surgery. For each type of cancer - colon, pancreas, oesogastric, hepatocellular carcinoma - morbidity and mortality rates are stated and compared with the oncological risk incurred by deferring surgery and/or the tumour doubling time. Strategies can be proposed based on this comparison. For colonic cancers T1-2, N0, it is advisable to defer surgery. For advanced colonic lesions, it seems judicious to undertake neoadjuvant chemotherapy and then wait. For rectal cancers T3-4 and /or N+, chemoradiotherapy is indicated, short radiotherapy must be discussed (followed by a waiting period) to reduce time of exposure in the hospital and to prevent infections. Most complex surgery with high morbidity and mortality - oesogastric, hepatic or pancreatic - is most often best deferred.</AbstractText><CopyrightInformation>© 2020 Elsevier Masson SAS. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tuech</LastName><ForeName>J-J</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Department of Digestive Surgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gangloff</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Di Fiore</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Michel</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brigand</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Slim</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of digestive surgery, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pocard</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>UMR 1275 CAP Paris-Tech, université de Paris, 75010 Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Service de chirurgie digestive et cancérologique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwarz</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Digestive Surgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UMR 1245 Inserm, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, UNIROUEN, Rouen University Hospital, Normandie Université, 76000 Rouen, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>fre</Language><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Stratégie pour la pratique de la chirurgie digestive et oncologique en situation d’épidémie de COVID-19.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>J Chir Visc</MedlineTA><NlmUniqueID>101530148</NlmUniqueID><ISSNLinking>1878-786X</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Cancer</Keyword><Keyword MajorTopicYN="N">Coronavirus</Keyword><Keyword MajorTopicYN="N">Digestive surgery</Keyword><Keyword MajorTopicYN="N">Surgical complications</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>25</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32834885</ArticleId><ArticleId IdType="doi">10.1016/j.jchirv.2020.03.007</ArticleId><ArticleId IdType="pii">S1878-786X(20)30052-8</ArticleId><ArticleId IdType="pmc">PMC7271206</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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Brigand</name><name sortKey="Di Fiore, F" sort="Di Fiore, F" uniqKey="Di Fiore F" first="F" last="Di Fiore">F. Di Fiore</name><name sortKey="Di Fiore, F" sort="Di Fiore, F" uniqKey="Di Fiore F" first="F" last="Di Fiore">F. Di Fiore</name><name sortKey="Gangloff, A" sort="Gangloff, A" uniqKey="Gangloff A" first="A" last="Gangloff">A. Gangloff</name><name sortKey="Michel, P" sort="Michel, P" uniqKey="Michel P" first="P" last="Michel">P. Michel</name><name sortKey="Michel, P" sort="Michel, P" uniqKey="Michel P" first="P" last="Michel">P. Michel</name><name sortKey="Pocard, M" sort="Pocard, M" uniqKey="Pocard M" first="M" last="Pocard">M. Pocard</name><name sortKey="Pocard, M" sort="Pocard, M" uniqKey="Pocard M" first="M" last="Pocard">M. Pocard</name><name sortKey="Schwarz, L" sort="Schwarz, L" uniqKey="Schwarz L" first="L" last="Schwarz">L. Schwarz</name><name sortKey="Schwarz, L" sort="Schwarz, L" uniqKey="Schwarz L" first="L" last="Schwarz">L. Schwarz</name><name sortKey="Slim, K" sort="Slim, K" uniqKey="Slim K" first="K" last="Slim">K. Slim</name><name sortKey="Tuech, J J" sort="Tuech, J J" uniqKey="Tuech J" first="J-J" last="Tuech">J-J Tuech</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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