Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy.
Int J Gynaecol Obstet. 2020 Aug;150(2):146-150. doi: 10.1002/ijgo.13248. Epub 2020 Jun 16.
Surgery in suspected/confirmed COVID-19 patients is a high-risk venture. In infected patients, COVID-19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID-19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone-sensitive pathologies should be implemented. Health risk assessment by patient history and COVID-19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID-19 patients or highly suspected cases, elective surgery should be postponed until full recovery.
在疑似/确诊 COVID-19 患者中进行手术是一项高风险的冒险。在感染患者中,COVID-19 存在于体腔中。在手术过程中,它可能会被手术器械产生的喷雾雾化,并从理论上感染手术团队的成员。然而,一些妇科的外科病理不能被推迟。我们根据专家意见、当前可用信息和国际科学学会的建议,列出了最常见的妇科疾病列表,并就 COVID-19 大流行期间的手术管理提出了建议,以支持全球妇科医生的工作。简而言之,如果可能的话,任何类型的手术治疗都应仔细审查并推迟。应实施包括针对激素敏感病变的药物治疗在内的非手术保守治疗。在择期手术前通过患者病史和 COVID-19 检测进行健康风险评估对于保护患者和医疗保健提供者至关重要。对于确诊的 COVID-19 患者或高度疑似病例,择期手术应推迟至完全康复后进行。