Organization of thoracic surgical services during the COVID pandemic

Abstract

Introduction COVID-19 presented an unprecedented challenge for healthcare workers and systems around the world. Healthcare systems have adapted differently in terms of pandemic planning of regular services, adopting infection control measures and prioritising essential hospital services in the context of a burgeoning COVID-19 patient load and inevitable surge. Methods We performed a review on current evidence and share our practices at a teaching hospital in Singapore. Results We outline principles and make recommendations for continuity of delivering essential thoracic surgical services during this current outbreak. Conclusions The maintenance and provision of thoracic surgery services in this context requires good preplanning and vigilance to infection control measures across all levels.

Thoracic Anesthesia during the COVID-19 Pandemic: 2021 Updated Recommendations by the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC) Thoracic Subspecialty Committee

“…[click here] Such a risk requires consideration and may be mitigated in part by the donning of personal protective equipment (PPE) by surgeons, keeping the port sites and instruments clear of body fluids, avoiding the use of two-way insufflation devices, using lower insufflation pressures and the lowest power settings for electrosurgical dissection, evacuation of carbon dioxide before extracting the excised tissues or specimen, and using air filters for the gas. 69 , 70 [click here] A systematic review and meta-analysis concludes that there is insufficient evidence to recommend the laparoscopic approach over the open one for abdominal surgery in COVID-19 era. 71 In VATS, carbon dioxide insufflation is not used so the risk of aerosol generation may be even lower than in laparoscopic surgery.…”

From Pandemic to Endemic–Redefining Excellence in Thoracic Surgery Service Delivery

“…The wellness and safety of healthcare staff is paramount and must be protected (12,13). As thoracic surgery is an aerosolgenerating procedure (14), we need to be mindful to ensure appropriate personal protective measures are taken during and after surgery to avoid exposure to our staff (7,12,15). In the event of personal protective equipment (PPE) shortages, allocation and utilization of PPE may have to be rationalized.…”

“…This pandemic has catalyzed the digitization of healthcare and we should continue to embrace it. Virtual based care, teleconsultations, home-based nursing and rehabilitation therapy, and home delivery services for prescription medicines can help to reduce footfall and congregation in the hospitals where Covid-19 patients are more likely to be encountered (3,7,10). From automated patient servicing counters to electronic hospital apps to virtual staff meetings, even the least tech-savvy of us will have to eventually accept this new normal (3,7).…”

Airway Surgery for Laryngotracheal Stenosis During the COVID-19 Pandemic: Institutional Guidelines

“…Health-care systems have adapted differently in terms of COVID-19 planning of adopting infection control measures, providing regular health services, and prioritizing essential hospital services in the context of a burning pandemic patient load and inevitable surge. The maintenance and provision of specialized thoracic surgery services in this context requires good pre-planning and vigilance to infection control measures across all levels ( 2 ).…”