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[新型冠状病毒肺炎大流行期间的重建手术方案建议。]

[Reconstructive surgery protocol recommendations during COVID-19 pandemia.].

作者信息

Bonillo-García Miguel Ángel, Morán-Pascual Eduardo, Puche-Sanz Ignacio, Campos-Juanatey Felix, Martínez-Piñeiro Luis, Ponce de León-Roca Javier

机构信息

Sección de Urología Reconstructiva y Funcional. Hospital Universitari i Politècnic La Fe. Valencia. España.

Servicio de Urología. Hospital Universitario Virgen de las Nieves. Inst Invest Biosanitaria Ibs. Granada. España.

出版信息

Arch Esp Urol. 2020 Jun;73(5):413-419.

Abstract

Offer some recommendations or guidelines during the evolution of the COVID-19 pandemic in terms of diagnosis, treatment and follow-upin the field of Reconstructive Urology. MATERIAL AND METHOD: The document is based on the evidence on SARS/Cov-2 and the authors' experience in managing COVID-19 in their institutions, including specialists from Andalusia, Madrid, Cantabria,the Valencian Community and Catalonia. A web and PubMed search was performed using "SARS-CoV-2", "COVID-19", "COVID-19 Urology", "COVID19 urology complications", "COVID-19 reconstructive surgery".A narrative review of the literature was carried out (5/17/2020) and after the nominal group technique modified due to the extraordinary restrictions, a first draft was made to unify criteria and reach a quick consensus. Finally, a definitive version was made, agreed by all the authors (5/22/2020). RESULTS: The authors defined the following surgical priorities for Urological Reconstructive Surgery: Emergency/Urgency (life-threatening or emergencies still in anormal situation), Elective Urgency/High priority (potentially dangerous pathology if postponed for more than 1month), Elective Surgery/Intermediate priority (pathology with little probability of being dangerous but it is recommended not to delay more than 6 months), Delayed surgery/Low priority (non-dangerous pathology if it is postponed for more than 6 months). According to this classification, the Working Group agreed on the distribution of the different surgical scenarios of Reconstructive Urology. In addition, consensus was reached on recommendations regarding the diagnosis and follow-up of pathology in the field of Reconstructive Urology. CONCLUSIONS: Tools should be implemented to facilitate the gathering of the medical visit and diagnostic tests. Redistribution of surgical procedures based on priority degrees is necessary during the pandemic and transition period. The use of telemedicine is essential forfollow-up, by computer, telephone or videoconference.

摘要

在新型冠状病毒肺炎大流行期间,就重建泌尿外科领域的诊断、治疗及随访提供一些建议或指导方针。材料与方法:本文件基于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的相关证据以及作者所在机构管理新型冠状病毒肺炎的经验,作者包括来自安达卢西亚、马德里、坎塔布里亚、巴伦西亚自治区和加泰罗尼亚的专家。使用“SARS-CoV-2”“新型冠状病毒肺炎”“新型冠状病毒肺炎泌尿外科”“新型冠状病毒肺炎泌尿外科并发症”“新型冠状病毒肺炎重建手术”在网络及PubMed上进行检索。于2020年5月17日对文献进行叙述性综述,并在因特殊限制而修改的名义小组技术之后,制定初稿以统一标准并迅速达成共识。最后,形成最终版本,由所有作者于2020年5月22日达成一致。结果:作者为泌尿外科重建手术确定了以下手术优先级:急诊/紧急情况(危及生命或仍处于正常情况的紧急情况)、择期紧急/高优先级(如果推迟超过1个月有潜在危险的病理情况)、择期手术/中等优先级(危险性较小但建议不延迟超过6个月的病理情况)、延迟手术/低优先级(如果推迟超过6个月无危险的病理情况)。根据此分类,工作组就重建泌尿外科不同手术场景的分配达成一致。此外,就重建泌尿外科领域病理诊断及随访的建议达成共识。结论:应采用工具以便利医疗问诊及诊断检查的开展。在大流行及过渡期间,有必要根据优先级重新分配手术程序。通过计算机、电话或视频会议进行远程医疗随访至关重要。

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