Department of Surgical Sciences, University of Torino, Corso AM Dogliotti 14, 10126, Torino, Italy.
Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK.
Surg Endosc. 2021 Jan;35(1):1-17. doi: 10.1007/s00464-020-08131-0. Epub 2020 Nov 10.
COVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts' opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic.
Recommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement.
A total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus.
The recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems.
COVID-19 大流行给整个外科界,尤其是微创外科(MIS)专家带来了意想不到的挑战。本文旨在总结最新证据和专家意见,提出建议,为外科界提供指导,以制定在 COVID-19 大流行后如何针对不同亚专业更好地组织外科活动的恢复计划。
采用德尔菲法建立专家共识来制定建议。根据 COVID-19 危机,制定了领域主题,并随后将其细分为不同外科专业的相关问题。邀请了来自 24 个国家的 65 名专家,代表整个 EAES 委员会。24 名临床医生和 6 名工程师接受了邀请,并根据具体关键问题起草了陈述。对陈述进行匿名投票,直至达成共识,即至少 70%的人同意。
共制定了 92 项关于在八个领域安全恢复手术的共识陈述,涵盖普通外科、上消化道、下消化道、减重、内分泌、肝胆胰、腹壁和技术/研究。这些陈述涉及所有亚专业的择期和急诊服务,并特别关注 MIS 在恢复计划中的作用。84 项陈述在第一轮德尔菲投票中获得通过(91.3%),在随后的一轮投票中,在进行实质性修改后,又有 8 项陈述获得通过,达成 100%的共识。
EAES 委员会制定的建议为 COVID-19 大流行后恢复手术建立了一个框架,特别强调了 MIS 在外科各专业中的作用。这些陈述有可能在不同医疗保健系统的临床环境、教育活动和研究工作中得到广泛应用。