Are urologists in trouble with SARS‐CoV‐2? Reflections and recommendations for specific interventions
Autor: | Germar M. Pinggera, Yannic Kunz, Wolfgang Horninger |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Suction (medicine)
medicine.medical_specialty Operating Rooms Infectious Disease Transmission Patient-to-Professional medicine.medical_treatment Urology 03 medical and health sciences Feces 0302 clinical medicine Pneumoperitoneum Risk Factors medicine Intubation Humans 030212 general & internal medicine RNA Messenger Intensive care medicine Contraindication Personal Protective Equipment Aerosols Infection Control Transmission (medicine) business.industry SARS-CoV-2 Risk of infection Contraindications COVID-19 Guideline Original Articles Hepatitis B medicine.disease Virus Diseases 030220 oncology & carcinogenesis Practice Guidelines as Topic Urologic Surgical Procedures Laparoscopy Original Article business Filtration |
Zdroj: | BJU International Bju International |
ISSN: | 1464-410X 1464-4096 |
DOI: | 10.1111/bju.15141 |
Popis: | To assess the risk of viral infection during urological surgeries due to the possible hazards in tissue, blood, urine and aerosolised particles generated during surgery, and thus to understand the risks and make recommendations for clinical practice.We reviewed the available literature on urological and other surgical procedures in patients with virus infections, such as human papillomavirus, human immunodeficiency virus and hepatitis B, and current publications on coronavirus disease 2019 (COVID-19).Several possible pathways for viral transmission appear in the literature. Recently, groups have detected severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the urine and faeces, even after negative pharyngeal swabs. In addition, viral RNA can be detected in the blood and several tissues. During surgery, viral particles are released, aerosol-borne and present a certain risk of transmission and infection. However, there is currently no evidence on the exact risk of infection from the agents mentioned above. It remains unclear whether or not viral particles in the urine, blood or faeces are infectious.Whether SARS-CoV-2 can be transmitted by aerosols remains controversial. Irrespective of this, standard surgical masks offer inadequate protection from SARS-CoV-2. Full personal protective equipment, including at least filtering facepiece-2 masks and safety goggles should be used. Aerosolised particles might remain for a long time in the operating theatre and contaminate other surfaces, e.g. floors or computer input devices. Therefore, scrupulous hygiene and disinfection of surfaces must be carried out. To prevent aerosolisation during laparoscopic interventions, the pneumoperitoneum should be evacuated with suction devices. The use of virus-proof high-efficiency particulate air filters is recommended. Local separation of anaesthesia/intubation and the operating theatre can reduce the danger of viral transmission. Lumbar anaesthesia should be considered especially in endourology. Based on current knowledge, COVID-19 is not a contraindication for acute urological surgery. However, if possible, as European guideline committees recommend, non-emergency urological interventions should be postponed until negative SARS-CoV-2 tests become available. |
Databáze: | OpenAIRE |
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