Pediatric surgery during the COVID-19 pandemic

作     者：Aikaterini Dedeilia Stepan M Esagian Ioannis A Ziogas Dimitrios Giannis Ioannis Katsaros GeorgiosTsoulfas 

作者机构：Surgery Working GroupSociety of Junior DoctorsAthens 15123Greece National and Kapodistrian University of AthensAthens 15772Greece Department of SurgeryDivision of Hepatobiliary Surgery and Liver TransplantationVanderbilt University Medical CenterNashvilleTN 37232United States Institute of Health Innovations and Outcomes Researchthe Feinstein Institute forΜedical ResearchManhassetNY 11030United States Department of SurgeryMetaxa Cancer HospitalPiraeus 18537Greece First Department of SurgeryAristotle University of ThessalonikiThessaloniki 54622Greece 

出 版 物：《World Journal of Clinical Pediatrics》 (世界临床儿科杂志)

年 卷 期：2020年第9卷第2期

页      面：7-16页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Pediatric surgery COVID-19 SARS-CoV-2 Coronavirus Emergency surgery Personal protective equipment 

摘      要：The coronavirus disease 2019(COVID-19)pandemic has had a major impact on pediatric surgery.The infection is often asymptomatic and atypical in children,while overlapping presentations with other infectious diseases generate additional diagnostic challenges.The high probability of missed pediatric cases and the invasive nature of surgery generate great concern for widespread transmission in this setting.Current guidelines suggest that triage of cases should be made on a case-by-case basis by a multidisciplinary team of experts.Decisionmaking can be assisted by classifying cases as elective,urgent,or an emergency according to the risks of delaying their surgical management.A workflow diagram should ideally guide the management of all cases from admission to discharge.When surgery is necessary,all staff should use appropriate personal protective equipment,and high-risk practices,such as aerosol-generating tools or procedures,should be avoided if possible.Furthermore,carefully designed organizational protocols should be established to minimize transmission while ensuring the uninterrupted operation of pediatric surgery units.For example,surgical teams can be divided into small weekly rotating groups,and healthcare workers should be continuously monitored for COVID-19 symptoms.Additionally,team protocols in the operating room can optimize communication and improve adherence to personal protective equipment use.Isolated operating rooms,pediatric intensive care units,and surgical wards should be specifically designed for suspected or confirmed COVID-19 cases.Finally,transportation of patients should be minimal and follow designated short routes.All these measures can help mitigate the effects of the COVID-19 pandemic on pediatric surgery units.