Recommandations CCAFU sur la prise en charge des cancers de l’appareil urogénital en période d’épidémie au Coronavirus COVID-19

Abstract

Pages 11 2 A. Méjean et al. Résultats. -La prise en charge médicale et chirurgicale des patients atteints de cancers de l'appareil urinaire et génital masculin doit être adaptée en modifiant les modalités de consultation, en priorisant les interventions en fonction du pronostic intrinsèque des cancers en tenant compte des comorbidités du patient. La protection des urologues vis-à-vis du COVID-19 doit être prise en considération. Conclusion. -Le CCAFU émet un avis d'experts quant aux mesures à prendre pour adapter la prise en charge des cancers de l'appareil urinaire et génital masculin au contexte de pandémie par COVID-19. Summary Aim. -The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. Material and method. -An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). Results. -The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. Conclusion. -The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.

Widespread Postponement of Functional Urology Cases During the COVID-19 Pandemic: Rationale, Potential Pitfalls, and Future Consequences

“…Owing to the recent emergence and rapid spread of SARS coronavirus 2, many national health authorities are recommending cancellation of scheduled elective surgeries and office visits [1][2][3][4][5]. The objectives are to increase the availability of inpatient and intensive care unit beds, to permit internal redeployment of medical staff and nurses, and to avoid overwhelming the health care systems.…”

“…In the field of urological oncology, national and international guidance have recently provided valuable information for adapting patient care during the current pandemic [3,5]. Life-threatening or rapidly progressing malignant diseases (eg, muscle-invasive bladder cancer and testicular tumours) have been set as surgical priorities for which the usual standard of care should be maintained.…”

Contamination risk in urology operating room during the COVID-19 pandemic

“…8 Also, intraperitoneal CO 2 should be extracted using the active smoke evacuation mode. 9 Moreover, some authors have suggested that use of laparoscopy should be reserved for COVID-19 negative patients, except for cases in which the risks of laparotomy far outweigh the risks of laparoscopy. 10 For endoscopic surgery in suspected or confirmed COVID-19 patients, complete protection against infection is recommended.…”

“…10 For endoscopic surgery in suspected or confirmed COVID-19 patients, complete protection against infection is recommended. 2,9 The same precaution needs to be taken when the anus is accessible in the operating field. 9 Healthcare workers in contact with such patients must also wear a double pair of gloves and long shoe covers.…”

“…2,9 The same precaution needs to be taken when the anus is accessible in the operating field. 9 Healthcare workers in contact with such patients must also wear a double pair of gloves and long shoe covers. Bowel utilization, such as in enterocystoplasty, should also be careful and kept to minimum because of the presence of SARS-CoV-2 in feces.…”