Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic.
Identifieur interne : 000571 ( Main/Exploration ); précédent : 000570; suivant : 000572Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic.
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 of visceral surgery [ 1878-7886 ] ; 2020.
Descripteurs français
- KwdFr :
- Besoins et demandes de services de santé (MeSH), Délai jusqu'au traitement (MeSH), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Infections à coronavirus (MeSH), Laparoscopie (MeSH), Maladies de l'appareil digestif (chirurgie), Pandémies (MeSH), Pneumopathie virale (MeSH), Soins postopératoires (MeSH), Tumeurs de l'appareil digestif (chirurgie).
- MESH :
English descriptors
- KwdEn :
- Coronavirus Infections (MeSH), Digestive System Diseases (surgery), Digestive System Neoplasms (surgery), Health Services Needs and Demand (MeSH), Humans (MeSH), Laparoscopy (MeSH), Pandemics (MeSH), Pneumonia, Viral (MeSH), Postoperative Care (MeSH), Practice Guidelines as Topic (MeSH), Time-to-Treatment (MeSH).
- MESH :
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.jviscsurg.2020.03.008
PubMed: 32249098
PubMed Central: PMC7269902
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
Links toward previous steps (curation, corpus...)
Le document en format XML
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<term>Digestive System Neoplasms (surgery)</term>
<term>Health Services Needs and Demand (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Laparoscopy (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (MeSH)</term>
<term>Postoperative Care (MeSH)</term>
<term>Practice Guidelines as Topic (MeSH)</term>
<term>Time-to-Treatment (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Besoins et demandes de services de santé (MeSH)</term>
<term>Délai jusqu'au traitement (MeSH)</term>
<term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (MeSH)</term>
<term>Laparoscopie (MeSH)</term>
<term>Maladies de l'appareil digestif (chirurgie)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (MeSH)</term>
<term>Soins postopératoires (MeSH)</term>
<term>Tumeurs de l'appareil digestif (chirurgie)</term>
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<keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Maladies de l'appareil digestif</term>
<term>Tumeurs de l'appareil digestif</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Digestive System Diseases</term>
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<term>Health Services Needs and Demand</term>
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<term>Laparoscopy</term>
<term>Pandemics</term>
<term>Pneumonia, Viral</term>
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<term>Délai jusqu'au traitement</term>
<term>Guides de bonnes pratiques cliniques comme sujet</term>
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<term>Infections à coronavirus</term>
<term>Laparoscopie</term>
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<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>
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<Title>Journal of visceral surgery</Title>
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<ArticleTitle>Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic.</ArticleTitle>
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<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>Copyright © 2020 Elsevier Masson SAS. All rights reserved.</CopyrightInformation>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tuech</LastName>
<ForeName>J-J</ForeName>
<Initials>JJ</Initials>
<AffiliationInfo><Affiliation>Rouen University Hospital, Department of Digestive Surgery, 1, rue de Germont, 76031 Rouen cedex, France; Normandie University, UNIROUEN, UMR 1245 Inserm, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, 76000 Rouen, France. Electronic address: jean-jacques.tuech@chu-rouen.fr.</Affiliation>
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<Author ValidYN="Y"><LastName>Gangloff</LastName>
<ForeName>A</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Rouen University Hospital, Department of Digestive Oncology, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Di Fiore</LastName>
<ForeName>F</ForeName>
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<AffiliationInfo><Affiliation>Normandie University, UNIROUEN, UMR 1245 Inserm, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, 76000 Rouen, France; Rouen University Hospital, Department of Digestive Oncology, 1, rue de Germont, 76031 Rouen cedex, France.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Michel</LastName>
<ForeName>P</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Normandie University, UNIROUEN, UMR 1245 Inserm, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, 76000 Rouen, France; Rouen University Hospital, Department of Digestive Oncology, 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 Clermont-Ferrand, 63003 Clermont-Ferrand, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pocard</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Université de Paris, UMR 1275 CAP Paris-Tech, 75010 Paris, France; 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>Rouen University Hospital, Department of Digestive Surgery, 1, rue de Germont, 76031 Rouen cedex, France; Normandie University, UNIROUEN, UMR 1245 Inserm, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, 76000 Rouen, France.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>03</Month>
<Day>31</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>France</Country>
<MedlineTA>J Visc Surg</MedlineTA>
<NlmUniqueID>101532664</NlmUniqueID>
<ISSNLinking>1878-7886</ISSNLinking>
</MedlineJournalInfo>
<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Visc Surg. 2020 Jun;157(3 Suppl 1):S65</RefSource>
<PMID Version="1">32305341</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="CommentIn"><RefSource>J Visc Surg. 2020 Jun;157(3 Suppl 1):S67-S68</RefSource>
<PMID Version="1">32327325</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="CommentIn"><RefSource>J Visc Surg. 2020 Jun;157(3 Suppl 1):S69-S70</RefSource>
<PMID Version="1">32381427</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="CommentIn"><RefSource>J Visc Surg. 2020 Aug;157(4):363</RefSource>
<PMID Version="1">32620503</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<MeshHeadingList><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004066" MajorTopicYN="N">Digestive System Diseases</DescriptorName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004067" MajorTopicYN="N">Digestive System Neoplasms</DescriptorName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006301" MajorTopicYN="N">Health Services Needs and Demand</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010535" MajorTopicYN="N">Laparoscopy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011182" MajorTopicYN="N">Postoperative Care</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D061665" MajorTopicYN="N">Time-to-Treatment</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Cancer</Keyword>
<Keyword MajorTopicYN="N">Coronavirus</Keyword>
<Keyword MajorTopicYN="N">Covid-19</Keyword>
<Keyword MajorTopicYN="N">Digestive surgery</Keyword>
<Keyword MajorTopicYN="N">Surgical complications</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>4</Month>
<Day>7</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>7</Month>
<Day>7</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
<Month>4</Month>
<Day>7</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">32249098</ArticleId>
<ArticleId IdType="pii">S1878-7886(20)30070-9</ArticleId>
<ArticleId IdType="doi">10.1016/j.jviscsurg.2020.03.008</ArticleId>
<ArticleId IdType="pmc">PMC7269902</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>France</li>
</country>
<region><li>Alsace (région administrative)</li>
<li>Auvergne (région administrative)</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Grand Est</li>
<li>Haute-Normandie</li>
<li>Région Normandie</li>
<li>Île-de-France</li>
</region>
<settlement><li>Clermont-Ferrand</li>
<li>Paris</li>
<li>Rouen</li>
<li>Strasbourg</li>
</settlement>
</list>
<tree><country name="France"><region name="Région Normandie"><name sortKey="Tuech, J J" sort="Tuech, J J" uniqKey="Tuech J" first="J-J" last="Tuech">J-J Tuech</name>
</region>
<name sortKey="Brigand, C" sort="Brigand, C" uniqKey="Brigand C" first="C" last="Brigand">C. 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="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="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="Slim, K" sort="Slim, K" uniqKey="Slim K" first="K" last="Slim">K. Slim</name>
</country>
</tree>
</affiliations>
</record>
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