de Cássio Zequi Stênio, Franca Silva Ivan Leonardo Avelino, Duprat João Pedreira, Coimbra Felipe José Fernandez, Gross Jefferson L, Vartanian Jose Guilherme, Makdissi Fabiana Baroni Alves, Leite Fernanda Perez M, Costa Walter Henriques da, Yazbek Guilherme, Joaquim Eduardo Henrique Giroud, Bussolotti Raquel Marcondes, Caruso Pedro, de Ávila Lima Marcon Censoni, Nakagawa Suely Akiko, Aguiar Samuel, Baiocchi Glauco, Lopes Ademar, Kowalski Luiz Paulo
Department of Urology, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil.
Department of Infectious Diseases, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil.
J Surg Oncol. 2021 May;123(8):1659-1668. doi: 10.1002/jso.26452. Epub 2021 Mar 8.
Cancer patients configure a risk group for complications or death by COVID-19. For many of them, postponing or replacing their surgical treatments is not recommended. During this pandemic, surgeons must discuss the risks and benefits of treatment, and patients should sign a specific comprehensive Informed consent (IC).
To report an IC and an algorithm developed for oncologic surgery during the COVID-19 outbreak.
We developed an IC and a process flowchart containing a preoperative symptoms questionnaire and a PCR SARS-CoV-2 test and described all perioperative steps of this program.
Patients with negative questionnaires and tests go to surgery, those with positive ones must wait 21 days and undergo a second test before surgery is scheduled. The IC focused both on risks and benefits inherent each surgery and on the risks of perioperative SARS-CoV-2 infections or related complications. Also, the IC discusses the possibility of sudden replacement of medical staff member(s) due to the pandemic; the possibility of unexpected complications demanding emergency procedures that cannot be specifically discussed in advance is addressed.
During the pandemic, specific tools must be developed to ensure safe experiences for surgical patients and prevent them from having misunderstandings concerning their care.
癌症患者构成了感染新型冠状病毒肺炎并出现并发症或死亡的风险群体。对于他们中的许多人来说，不建议推迟或更换手术治疗。在此次疫情期间，外科医生必须讨论治疗的风险和益处，患者应签署一份特定的全面知情同意书（IC）。
报告在新型冠状病毒肺炎疫情期间为肿瘤外科手术制定的一份知情同意书和一种算法。
我们制定了一份知情同意书和一个包含术前症状问卷及新型冠状病毒聚合酶链式反应（PCR）检测的流程图，并描述了该方案的所有围手术期步骤。
问卷和检测结果为阴性的患者可进行手术，结果为阳性的患者必须等待21天，并在安排手术前接受第二次检测。知情同意书既关注了每台手术固有的风险和益处，也关注了围手术期感染新型冠状病毒或出现相关并发症的风险。此外，知情同意书还讨论了因疫情导致医护人员突然更换的可能性；提到了出现需要紧急手术但无法提前具体讨论的意外并发症的可能性。
在疫情期间必须开发特定工具，以确保外科手术患者有安全的体验，并防止他们对自身护理产生误解。
