Endocrine Surgery during the COVID-19 Pandemic: Recommendations from the Turkish Association of Endocrine Surgery

Abstract

The 2019 novel coronavirus disease (COVID-19) was initially seen in Wuhan, China, in December 2019. World Health Organizationclassified COVID-19 as a pandemic after its rapid spread worldwide in a few months. With the pandemic, all elective surgeries andnon-emergency procedures have been postponed in our country, as in others. Most of the endocrine operations can be postponedfor a certain period. However, it must be kept in mind that these patients also need surgical treatment, and the delay time shouldnot cause a negative effect on the surgical outcome or disease process. It has recently been suggested that elective surgical interventionscan be described as medically necessary, time-sensitive (MeNTS) procedures.Some guidelines have been published on proper and safe surgery for both the healthcare providers and the patients after theimmediate onset of the COVID-19 pandemic. We should know that these guidelines and recommendations are not meant toconstitute a position statement, the standard of care, or evidence-based/best practice. However, these are mostly the opinionsof a selected group of surgeons. Generally, only life-threatening emergency operations should be performed in the stage wherethe epidemic exceeds the capacity of the hospitals (first stage), cancer and transplantation surgery should be initiated when theoutbreak begins to be controlled (second stage), and surgery for elective cases should be performed in a controlled manner withsuppression of the outbreak (third stage).In this rapidly developing pandemic period, the plans and recommendations to be made on this subject are based on expert opinionsby considering factors, such as the course and biology of the disease, rather than being evidence-based. In the recent reportsof many endocrine surgery associations and in various reviews, it has been stated that most of the cases can be postponed to thethird stage of the epidemic.We aimed to evaluate the risk reduction strategies and recommendations that can help plan the surgery, prepare for surgery, protectboth patients and healthcare workers during the operation and care for the patients in the postoperative period in endocrine surgery.