key: cord-312398-teu3tdbq
authors: Pocard, Marc
title: A special edition of the Journal of Visceral Surgery on Covid-19: what problems, dangers and solutions have been identified?
date: 2020-05-04
journal: J Visc Surg
DOI: 10.1016/j.jviscsurg.2020.04.019
sha: 
doc_id: 312398
cord_uid: teu3tdbq

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J o u r n a l P r e -p r o o f course, depending on our respective situations, this balancing act will be perceived differently. So, how will cancer surgery go forward? And this perception will evolve over time depending on the progression and the phases of the pandemic. There are others who are not persuaded by this notion of excess-risk and anticipate, with good reason, a massive influx of surgical cases in a few weeks. Based on this analysis, these colleagues believe that it is therefore necessary to continue to operate on patients with cancer if that is possible.

Operating at all costs, trying to adapt and be inventive--this is the point of view defended by one of our colleagues who works in an area heavily affected by the SARS epidemic (6) .

How can we best manage risks about which we still know so little? Because, yes! the risks are multiple. Thus, if in France tomorrow, a Regional Health Agency (ARS) should require a surgical team to move to a Covid-19-negative center in order to perform cancer surgery, should this be seen as an element of progress and finally an organization that transcends the divides between public and private medicine? Is there a positive effect of this crisis? Yes, unless this leads to cancer surgery being performed in a Level I center that lacks the authorization (by this same ARS) to operate on cancers.

J o u r n a l P r e -p r o o f However, cancer surgery must meet quality criteria, and these criteria are not exclusively linked to the surgeon. If the center does not meet the quality criteria for anesthesia, resuscitation and pathology because of too little oncologic activity -where do we go next? Are we going to deliver uncertain or suboptimal cancer treatments to patients in order to fill in boxes in an Excel spreadsheet?

There is also risk that in the aftermath of Covid-19, we will no longer be able to tell these This induces complex situations in ER's and this is highlighted in two texts of this special issue (8, 9) . The clinical symptoms of a patient with Covid-19 infection may be predominantly gastro-intestinal or full-blown respiratory symptoms, as the mini-review will tell you (10).

We must be vigilant in case of appendicitis, vigilant for the diagnosis and proceed with a CT scan that includes the lungs.

Such a case is presented in this issue (11) choices. Hold out, because it is probably there, in the emergency room, that our skills as surgeons will be most useful during this appalling turmoil and where we will be able to save lives. Because, with or without the virus, peritonitis also kills.

Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic -FRANCOGYN group for the CNGOF

Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection

Nosocomial infection with SARS-Cov-2 in the Digestive Surgery departments

Re: Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

Endocrine surgery during and after the Covid-19 epidemic: Expert guidelines in France

Urgent digestive surgery, a collateral victim of the Covid-19 crisis?

Re: Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

What surgeons need to know about digestive disorders and paraclinical abnormalities induced by COVID-19?

SARS-CoV-2 infection may result in appendicular syndrome: chest CT scan before appendectomy

Risks of viral contamination in healthcare professionals during laparoscopy in the Covid-19 pandemic