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首页> 外文期刊>Surgical endoscopy >ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases
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ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases

机译：ELSA对社区传播大流行期间微创手术的建议：亚洲从广泛到恢复阶段的集中方法

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Background The COVID-19 pandemic has resulted in significant changes to surgical practice across the worlds. Some countries are seeing a tailing down of cases, while others are still having persistent and sustained community spread. These evolving disease patterns call for a customized and dynamic approach to the selection, screening, planning, and for the conduct of surgery for these patients. Methods The current literature and various international society guidelines were reviewed and a set of recommendations were drafted. These were circulated to the Governors of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA) for expert comments and discussion. The results of these were compiled and are presented in this paper. Results The recommendations include guidance for selection and screening of patients in times of active community spread, limited community spread, during times of sporadic cases or recovery and the transition between phases. Personal protective equipment requirements are also reviewed for each phase as minimum requirements. Capability management for the re-opening of services is also discussed. The choice between open and laparoscopic surgery is patient based, and the relative advantages of laparoscopic surgery with regard to complications, and respiratory recovery after major surgery has to be weighed against the lack of safety data for laparoscopic surgery in COVID-19 positive patients. We provide recommendations on the operating room set up and conduct of general surgery. If laparoscopic surgery is to be performed, we describe circuit modifications to assist in reducing plume generation and aerosolization. Conclusion The COVID-19 pandemic requires every surgical unit to have clear guidelines to ensure both patient and staff safety. These guidelines may assist in providing guidance to units developing their own protocols. A judicious approach must be adopted as surgical units look to re-open services as the pandemic evolves.
机译：背景 COVID-19 大流行导致世界各地的外科实践发生了重大变化。一些国家的病例正在减少，而另一些国家仍在持续不断地传播社区。这些不断变化的疾病模式需要一种定制和动态的方法来选择、筛查、计划和为这些患者进行手术。方法 回顾了当前文献和各种国际社会指南，并起草了一套建议。这些报告已分发给亚洲内窥镜和腹腔镜外科医生协会（ELSA）的理事，以征求专家意见和讨论。本文汇编了这些结果，并进行了介绍。结果 这些建议包括在社区传播活跃期、有限社区传播期、散发病例或康复期以及阶段之间的过渡期间对患者的选择和筛查提供指导。每个阶段的个人防护设备要求也作为最低要求进行审查。还讨论了重新开放服务的能力管理。开放手术和腹腔镜手术之间的选择以患者为基础，腹腔镜手术在并发症和大手术后呼吸恢复方面的相对优势必须与缺乏 COVID-19 阳性患者腹腔镜手术的安全性数据进行权衡。我们提供有关手术室设置和普通外科手术的建议。如果要进行腹腔镜手术，我们会描述回路修改，以帮助减少羽流产生和气溶胶化。结论 COVID-19 大流行要求每个手术单位都有明确的指导方针，以确保患者和工作人员的安全。这些准则可能有助于为制定自己的协议的单位提供指导。随着大流行的发展，外科单位希望重新开放服务，因此必须采取明智的方法。

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