Intraoperative aerosol viral transmission in minimally invasive surgery: A scoping review and impact on clinical guidelines and practice during the onset of the COVID-19 pandemic.
Identifieur interne : 000C45 ( Main/Exploration ); précédent : 000C44; suivant : 000C46Intraoperative aerosol viral transmission in minimally invasive surgery: A scoping review and impact on clinical guidelines and practice during the onset of the COVID-19 pandemic.
Auteurs : Dong-Ho Mun [Autriche] ; Benjamin Pradere [Autriche, France] ; Shahrokh F. Shariat [Autriche, Russie, États-Unis, République tchèque, Jordanie, Pays-Bas] ; Mesut Remzi [Autriche]Source :
- BJU international [ 1464-410X ] ; 2020.
Abstract
OBJECTIVE
To identify the available evidence on aerosol viral transmission risk during minimally invasive surgery (MIS) and evaluate its impact on guidelines development and clinical activity worldwide during the COVID-19 pandemic.
MATERIALS AND METHODS
We performed a scoping review on PubMed, Cochrane, Embase, clinical trial register, and grey literature repository databases to identify reports on viral transmission via surgical smoke or aerosolization. A systematic review of all available national and international guidelines was also performed to report their recommendations. Additionally, a worldwide transdisciplinary survey was performed to capture the actual compliance to dedicated guidelines and their impact on minimally invasive surgical activity.
RESULTS
Based on a selection of 17 studies, there is no evidence to support the concerns of an intraoperative viral transmission via pneumoperitoneum aerosolization. Most national surgical and urologic societies either did address this topic or referred to international guidelines. The guidelines of the American College of Surgery, the Royal College of Surgeons and the European Association of Urology Robotic Urology Section recommended an avoidance of MIS due to an increased risk of intraoperative aerosol-enhanced transmission. The results of the survey completed by 334 respondents, from different surgical abdominal specialties, suggested a lack of compliance with the guidelines.
CONCLUSION
There seems to be a dissonance between contemporary guidelines and ongoing surgical activity, possibly due to the perceived lack of evidence. Recommendations regarding changes in clinical practice should be based on the best available research evidence and experience. A scoping review of the evidence and an assessment of the benefits and harms together with a survey showed that laparoscopic procedures do not seem to increase the risk of viral transmission. Nevertheless, the low number of publications and low quality of existing evidence limits the validity of the review.
DOI: 10.1111/bju.15247
PubMed: 32937006
Affiliations:
- Autriche, France, Jordanie, Pays-Bas, Russie, République tchèque, États-Unis
- Bohême centrale, District fédéral central, Texas, Vienne (Autriche), État de New York
- Moscou, Prague, Vienne (Autriche)
Links toward previous steps (curation, corpus...)
Le document en format XML
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A systematic review of all available national and international guidelines was also performed to report their recommendations. Additionally, a worldwide transdisciplinary survey was performed to capture the actual compliance to dedicated guidelines and their impact on minimally invasive surgical activity.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Based on a selection of 17 studies, there is no evidence to support the concerns of an intraoperative viral transmission via pneumoperitoneum aerosolization. Most national surgical and urologic societies either did address this topic or referred to international guidelines. The guidelines of the American College of Surgery, the Royal College of Surgeons and the European Association of Urology Robotic Urology Section recommended an avoidance of MIS due to an increased risk of intraoperative aerosol-enhanced transmission. The results of the survey completed by 334 respondents, from different surgical abdominal specialties, suggested a lack of compliance with the guidelines.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>There seems to be a dissonance between contemporary guidelines and ongoing surgical activity, possibly due to the perceived lack of evidence. Recommendations regarding changes in clinical practice should be based on the best available research evidence and experience. A scoping review of the evidence and an assessment of the benefits and harms together with a survey showed that laparoscopic procedures do not seem to increase the risk of viral transmission. Nevertheless, the low number of publications and low quality of existing evidence limits the validity of the review.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32937006</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1464-410X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Sep</Month><Day>16</Day></PubDate></JournalIssue><Title>BJU international</Title><ISOAbbreviation>BJU Int.</ISOAbbreviation></Journal><ArticleTitle>Intraoperative aerosol viral transmission in minimally invasive surgery: A scoping review and impact on clinical guidelines and practice during the onset of the COVID-19 pandemic.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1111/bju.15247</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To identify the available evidence on aerosol viral transmission risk during minimally invasive surgery (MIS) and evaluate its impact on guidelines development and clinical activity worldwide during the COVID-19 pandemic.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">We performed a scoping review on PubMed, Cochrane, Embase, clinical trial register, and grey literature repository databases to identify reports on viral transmission via surgical smoke or aerosolization. A systematic review of all available national and international guidelines was also performed to report their recommendations. Additionally, a worldwide transdisciplinary survey was performed to capture the actual compliance to dedicated guidelines and their impact on minimally invasive surgical activity.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Based on a selection of 17 studies, there is no evidence to support the concerns of an intraoperative viral transmission via pneumoperitoneum aerosolization. Most national surgical and urologic societies either did address this topic or referred to international guidelines. The guidelines of the American College of Surgery, the Royal College of Surgeons and the European Association of Urology Robotic Urology Section recommended an avoidance of MIS due to an increased risk of intraoperative aerosol-enhanced transmission. The results of the survey completed by 334 respondents, from different surgical abdominal specialties, suggested a lack of compliance with the guidelines.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">There seems to be a dissonance between contemporary guidelines and ongoing surgical activity, possibly due to the perceived lack of evidence. Recommendations regarding changes in clinical practice should be based on the best available research evidence and experience. A scoping review of the evidence and an assessment of the benefits and harms together with a survey showed that laparoscopic procedures do not seem to increase the risk of viral transmission. Nevertheless, the low number of publications and low quality of existing evidence limits the validity of the review.</AbstractText><CopyrightInformation>This article is protected by copyright. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mun</LastName><ForeName>Dong-Ho</ForeName><Initials>DH</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-6922-7754</Identifier><AffiliationInfo><Affiliation>Department of Urology, Medical University of Vienna, Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pradere</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-7768-8558</Identifier><AffiliationInfo><Affiliation>Department of Urology, Medical University of Vienna, Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Urology, CHRU Tours, Francois Rabelais University, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shariat</LastName><ForeName>Shahrokh F</ForeName><Initials>SF</Initials><AffiliationInfo><Affiliation>Department of Urology, Medical University of Vienna, Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Urology, Weill Cornell Medical College, New York, New York, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Urology, University of Texas Southwestern, Dallas, Texas, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>European Association of Urology Research Foundation, Arnhem, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Remzi</LastName><ForeName>Mesut</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Urology, Medical University of Vienna, Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chairman of the Laparoscopic and Robotic Surgery Section of the Austrian Urological Association.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BJU Int</MedlineTA><NlmUniqueID>100886721</NlmUniqueID><ISSNLinking>1464-4096</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">aerosol</Keyword><Keyword MajorTopicYN="N">intraoperative viral transmission</Keyword><Keyword MajorTopicYN="N">minimally invasive surgery</Keyword><Keyword MajorTopicYN="N">surgical smoke</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>16</Day><Hour>17</Hour><Minute>13</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32937006</ArticleId><ArticleId IdType="doi">10.1111/bju.15247</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Autriche</li><li>France</li><li>Jordanie</li><li>Pays-Bas</li><li>Russie</li><li>République tchèque</li><li>États-Unis</li></country><region><li>Bohême centrale</li><li>District fédéral central</li><li>Texas</li><li>Vienne (Autriche)</li><li>État de New York</li></region><settlement><li>Moscou</li><li>Prague</li><li>Vienne (Autriche)</li></settlement></list><tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Mun, Dong Ho" sort="Mun, Dong Ho" uniqKey="Mun D" first="Dong-Ho" last="Mun">Dong-Ho Mun</name></region><name sortKey="Pradere, Benjamin" sort="Pradere, Benjamin" uniqKey="Pradere B" first="Benjamin" last="Pradere">Benjamin Pradere</name><name sortKey="Remzi, Mesut" sort="Remzi, Mesut" uniqKey="Remzi M" first="Mesut" last="Remzi">Mesut Remzi</name><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F" last="Shariat">Shahrokh F. Shariat</name><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F" last="Shariat">Shahrokh F. Shariat</name></country><country name="France"><noRegion><name sortKey="Pradere, Benjamin" sort="Pradere, Benjamin" uniqKey="Pradere B" first="Benjamin" last="Pradere">Benjamin Pradere</name></noRegion></country><country name="Russie"><region name="District fédéral central"><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F" last="Shariat">Shahrokh F. Shariat</name></region></country><country name="États-Unis"><region name="État de New York"><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F" last="Shariat">Shahrokh F. Shariat</name></region><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F" last="Shariat">Shahrokh F. 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