Endocrine surgery during and after the COVID-19 epidemic: Expert guidelines from AFCE

“…Regarding the determination of patients who need urgent operations or those that can be safely deferred, many groups from other specialties including hepatobiliary, colorectal, and visceral surgeries reported guidelines or expert opinions [ 4 – 7 ]. However, for endocrine disorders, there is still scant and limited data in the literature [ 8 ]. Thus, there is no national or international case-based expert consensus or guidelines for endocrine disorders outlining alternative procedures for the conventional surgical algorithms.…”

Section: Discussionmentioning

confidence: 99%

Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

et al. 2021

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Purpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± β-blocker combination for Graves’ disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3–4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.

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“…There are special measures required for laparoscopic surgery; PPE should be worn by all those in operating theatre, due to risk of aerosols generation. Patients are scheduled according to emergency degree: urgent surgery -as soon as possible for those in a lifethreatening condition; semi-urgent condition in which a delay of 6-12 weeks would not change the prognosis; high priority elective surgery for those who can wait for several months, and distant elective, for more than 6 months, that can be deferred until well after the epidemic is over (11).…”

Section: Adrenal Disorders and Steroid Treatment During Covid 19mentioning

confidence: 99%

Endocrine Effects of Covid 19: Difficulties in the Management of Endocrine Disorders from Individual to Societies

Moroti

Badiu

2020

Acta Endo (Buc)

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Development of Covid-19 pandemic infection which started in December 2019 from Wuhan, China, impacted all medical specialities and societies. Endocrine professionals are involved in this battle, as far as many patients with endocrine co-morbidities (diabetes, metabolic syndrome, pituitary, thyroid, adrenal disorders) are most affected by the disease. Specific recommendations for the management of endocrine disorders were released by European experts. Most rely on the same principles of epidemiological safety measures, delaying non emergency admissions and transforming the routine follow-up in telemedicine clinics. Special attention is required to adrenal disorders, either central in the context of pituitary patients or primary. Corticosteroids are a mainstay of treatment in Covid-19 infection, therefore it is important to consider all aspects involved by high doses, including metabolic adverse reactions especially in diabetic patients. Other endocrine disorders, thyroid dysfunctions or nodules, parathyroid, adrenal, and pituitary diseases should follow specific recommendations for management. Surgery is postponed for non-emergency situations, restricting most planned surgeries, either thyroid, pituitary or adrenal. Laparoscopic surgery, if required in emergency, is including a supplementary risk, therefore all involved in the operating theater should wear PPE. In conclusion, a coordinated response should be organized in the multidisciplinary management of endocrine patients.

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Endocrine surgery during and after the COVID-19 epidemic: Expert guidelines from AFCE

Cited by 29 publications

References 46 publications

Impact of coronavirus disease 2019 (COVID-19) lockdown on in-hospital mortality and surgical activity in elective digestive resections: A nationwide cohort analysis

Impact of coronavirus disease 2019 (COVID-19) lockdown on in-hospital mortality and surgical activity in elective digestive resections: A nationwide cohort analysis

Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

Endocrine Effects of Covid 19: Difficulties in the Management of Endocrine Disorders from Individual to Societies

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