ASI’s Consensus Guidelines: ABCs of What to Do and What Not During the COVID-19 Pandemic

Somashekhar, S. P.; Shivaram, H. V.; Abhaham, Santhosh John; Dalvi, Abhay; Kumar, Arvind; Gode, Dilip; Misra, Shiva K.; Jain, Sanjay Kumar; Prasad, C. R. K.; Pillarisetti, Raghu Ram

doi:10.1007/s12262-020-02452-z

Cited by 25 publications

(22 citation statements)

References 19 publications

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“…A summary of all guidelines with the origin of their country, academic association, type of study, type of evidence, and recommendations based on various surgical/technical parameters are shown in Table 2 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, issues of resource optimization, geographical inclusion, and economic implications drew poor scores, even the guideline with the maximum score for quality of evidence scored poorly on this issue [12]. However, a couple of guidelines from LMICs scored maximum in these domains, demonstrating the weight of their input on such a crucial issue [5,17]. The end of COVID-19 is nowhere in sight, and its impact on global health will be long-lasting.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic Surgery guideline's highest overall mean score, it stood 2nd in resource optimization and 8th in economic implication domains [12]. Guidelines originating from LMICs stood poor on the evidence domain, but Indian Inter-Society guidelines and Association of Surgeons of India guidelines from LMICs scored maximum in the resource optimization and economic implication domains [5,17].…”

Section: Notwithstanding the Society Of American Gastrointestinal Andmentioning

confidence: 99%

“…Similarly, mean scores for the evidence (30.39%), methodology (40.41%), ease (40.41%), resource (32.07%), geography (52.07%), and economy (24.97%) domains were very modest. The Society of American Gastrointestinal and Endoscopic Surgeons & European Association for Endoscopic Surgery guideline scored highest (49.30%) followed by the Association of Surgeons of India (45.83%), Endoscopic and Laparoscopic Surgeons of Asia (45.13%), European Hernia Society (45.12%), and Indian Inter-Society guidelines (44.43%)[5,7,9,12,17]…”

mentioning

confidence: 99%

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Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

et al. 2020

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The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke and laparoscopy gas has led to the formulation of many guidelines during the COVID-19 pandemic. This rapid scoping review of these guidelines was done to assess the quality of their evidence and appraise them for their impact on surgical services from the global south. A simple quality appraisal tool was constructed which can be used to evaluate rapidly emerging guidelines for evidence as well as for the needs of the global south. This rapid scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Electronic databases were searched with predefined strategy and retrieved papers were screened according to relevant criteria. A simple objective tool to assess the quality of rapidly emerging guidelines including evidence, methodology, ease, resource optimization, geography, and the economy was constructed. Twenty studies met the inclusion criteria. None of the guidelines qualified to be evidence-based clinical practice guidelines as the level of evidence was uniformly rated "low". A newly constructed tool showed good validation, reliability, and internal consistency. This rapid scoping review found two major research gaps: lack of systematic review of evidence during their development and insufficient weightage of their impact on surgical services from the global south. These significant issues were addressed by constructing a simple and more representative tool for evaluating rapidly emerging guidelines which also gives the rightful importance of their impact on surgical services from the global south.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Notwithstanding the Society Of American Gastrointestinal Andmentioning

confidence: 99%

mentioning

confidence: 99%

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Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

et al. 2020

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“…These issues highlight the need for effective discussions between the surgeon and the patient, on how COVID-19 affects the surgical services and perioperative outcomes. Additional consent for impact of COVID-19 on outcomes has been recommended by various associations [8]. Few COVID-19-specific consent forms have been published online for use [9].…”

Section: Covid Times-surgical Consent Checklistmentioning

confidence: 99%

Surgical Consent during COVID Pandemic: COVID Times—Surgical Consent Checklist

Jose

Joy

2020

Indian J Surg

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COVID-19 caused many countries to stop their elective procedures to allow preservation of resources for COVID-19 care. With restriction being gradually lifted, the surgical services have to face the pending burden of elective cases alongside the pandemic. The true impact of the pandemic and the COVID-19 on perioperative outcomes is still being discovered. This demands a COVID-specific consenting process in addition to the routine surgical consent, to ensure that the patients are able to make informed decisions. The first ever COVID-specific checklist for surgical consent 'COVID times-surgical consent checklist' is introduced. This checklist enables the surgeon to ensure that a discussion detailing the impact of COVID-19 on surgical services is made. It also acts as a documentation of the discussions carried out during the consenting process.

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The PanSurg‐PREDICT Study: Endocrine Surgery During the COVID‐19 Pandemic

Kinross¹,

Beatty²,

Markar³

et al. 2021

World j. surg.

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Background In the midst of the COVID-19 pandemic, patients have continued to present with endocrine (surgical) pathology in an environment depleted of resources. This study investigated how the pandemic affected endocrine surgery practice. Methods PanSurg-PREDICT is an international, multicentre, prospective, observational cohort study of emergency and elective surgical patients in secondary/tertiary care during the pandemic. PREDICT-Endocrine collected endocrine-specific data alongside demographics, COVID-19 and outcome data from 11–3-2020 to 13–9-2020. Results A total of 380 endocrine surgery patients (19 centres, 12 countries) were analysed (224 thyroidectomies, 116 parathyroidectomies, 40 adrenalectomies). Ninety-seven percent were elective, and 63% needed surgery within 4 weeks. Eight percent were initially deferred but had surgery during the pandemic; less than 1% percent was deferred for more than 6 months. Decision-making was affected by capacity, COVID-19 status or the pandemic in 17%, 5% and 7% of cases. Indication was cancer/worrying lesion in 61% of thyroidectomies and 73% of adrenalectomies and calcium 2.80 mmol/l or greater in 50% of parathyroidectomies. COVID-19 status was unknown at presentation in 92% and remained unknown before surgery in 30%. Two-thirds were asked to self-isolate before surgery. There was one COVID-19-related ICU admission and no mortalities. Consultant-delivered care occurred in a majority (anaesthetist 96%, primary surgeon 76%). Post-operative vocal cord check was reported in only 14% of neck endocrine operations. Both of these observations are likely to reflect modification of practice due to the pandemic. Conclusion The COVID-19 pandemic has affected endocrine surgical decision-making, case mix and personnel delivering care. Significant variation was seen in COVID-19 risk mitigation measures. COVID-19-related complications were uncommon. This analysis demonstrates the safety of endocrine surgery during this pandemic.

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ASI’s Consensus Guidelines: ABCs of What to Do and What Not During the COVID-19 Pandemic

Cited by 25 publications

References 19 publications

Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

Surgical Consent during COVID Pandemic: COVID Times—Surgical Consent Checklist

The PanSurg‐PREDICT Study: Endocrine Surgery During the COVID‐19 Pandemic

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