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COVID-19 危机与微创手术:奥地利术中气溶胶病毒传播及其对指南和临床实践影响的叙事性综述。

COVID-19 crisis and minimally invasive surgery: a narrative review on intraoperative aerosol viral transmission and their impact on guidelines and clinical practice in Austria.

机构信息

Department of Urology, Medical University of Vienna, Vienna, Austria.

Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France.

出版信息

Curr Opin Urol. 2021 Jul 1;31(4):340-345. doi: 10.1097/MOU.0000000000000891.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to evaluate the risk of intraoperative aerosol viral transmission and the impact of updated COVID-19 guidelines on minimally invasive surgery (MIS) in Austria.

RECENT FINDINGS

The current literature does not support the risk of intraoperative viral transmission nor does it suggest a harm of minimally invasive procedures in the context of the COVID-19 pandemic. However, medical societies mostly adopted a precautionary approach with a focus on protective measures. Austrian surgeons considered MIS safe during the pandemic and Austria managed to keep the initial outbreak in control. Yet, MIS programs were still affected due to the postponements of elective procedures and switches to other methods by some surgeons.

SUMMARY

The postponement and cancellation of MIS caused complexities in health-care delivery in Austria, whilst the evidence to substantiate this precautionary approach is missing. It must be noted, both the guidelines and our review are limited by the scarcity of evidence. In further consequence, regional factors should be considered while taking precautions. Specific studies on the severe acute respiratory syndrome coronavirus type 2 transmission risk during MIS are urgently needed.

摘要

目的综述

本文旨在评估术中气溶胶病毒传播的风险,以及奥地利更新的 COVID-19 指南对微创手术(MIS)的影响。

最近的发现

目前的文献并不支持术中病毒传播的风险,也没有表明在 COVID-19 大流行背景下微创程序会造成危害。然而,医学协会大多采取预防措施,重点是保护措施。奥地利外科医生认为在大流行期间 MIS 是安全的,奥地利设法控制了最初的疫情爆发。然而,由于一些外科医生推迟了择期手术和改用其他方法,MIS 项目仍受到影响。

总结

在奥地利,MIS 的推迟和取消给医疗保健的提供带来了复杂性,而这种预防措施的证据尚缺乏。需要指出的是,指南和我们的综述都受到证据不足的限制。因此,在采取预防措施时应考虑区域因素。迫切需要针对 MIS 期间严重急性呼吸综合征冠状病毒 2 型传播风险的具体研究。

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