Surgical cancer care in the COVID-19 era: Front line views and consensus

Abstract

Objective: to suggest a script for surgical oncology assistance in COVID-19 pandemic in Brazil. Method: a narrative review and a “brainstorming” consensus were carried out after discussion with more than 350 Brazilian specialists and renowned surgeons from Portugal, France, Italy and United States of America. Results: consensus on testing for COVID-19: 1-All patients to be operated should be tested between 24 and 48 before the procedure; 2-The team that has contact with sick or symptomatic patients should be tested; 3-Chest tomography was suggested to investigate pulmonary changes. Consensus on protection of care teams: 1-Use of surgical masks inside the hospitals. Use of N95 masks for all professionals in the operating room; 2-Selection of cases for minimally invasive surgery and maximum pneumoperitoneal aspiration before removal of the surgical specimen; 2-Optimization of the number of people in teams, with a minimum number of professionals, reducing their occupational exposure, the consumption of protective equipment and the circulation of people in the hospital environment; 3-Isolation of contaminated patients. Priority consensus: 1-Construction of service priorities; 2-Interdisciplinary discussion on minimally invasive or conventional pathways. Conclusion: the Brazilian Society of Surgical Oncology (BSSO) suggests a script for coping with oncological treatment, remembering that the impoundment in the assistance of these cases, can configure a new wave of overload in health systems.