Endocrine Surgery in COVID-19 Pandemic: A Systematic Review

Abstract

Background: Coronavirus disease (Covid-19) took pandemic status after outbreak in Wuhan, China, in December 2019. In Pakistan, first case of Covid-19 was reported on February 26^th 2020. After striking peak during last week of June, it started declining in Pakistan. During next three  months it declined rapidly as compared to other countries. Our aim is to evaluate the current recommendations  based on review of literature that can help plan the surgery and protect both patients and healthcare workers, during and after pandemic.  

Methods: We reviewed several papers on endocrine surgery during covid-19 pandemic, published in leading journals. Different search engines were used including google, yahoo and bing. Recommendations about optimal timing for endocrine surgery during COVID-19 pandemic were evaluated.   

Results: As in other countries, all elective and non-emergency surgeries were postponed in Pakistan at mid of March 2020.  Most of the endocrine operations can be postponed for a certain period of time. During the process of covid-19 spread, guidelines for safe surgery were established by leading endocrine surgery societies.  Like other countries, Surgeries were started in three stages in Pakistan. During early days of pandemic life threatening surgeries were performed(First stage). Cancer surgeries were started when outbreak was being controlled(Second stage). Elective surgeries have been started recently with suppression of outbreak, taking all precautionary  measures during surgery(Third stage).   

Conclusion: In the light of various reports and  recent reviews of many endocrine surgery societies we may recommend that most of endocrine cases can be postponed to the third stage of the epidemic in Pakistan.