ISSN : 1302-7123 | E-ISSN : 1308-5123
The Medical Bulletin of Sisli Etfal Hospital
Endocrine Surgery during the COVID-19 Pandemic: Recommendations from the Turkish Association of Endocrine Surgery [SETB]
SETB. 2020; 54(2): 117-131 | DOI: 10.14744/SEMB.2020.65902

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

Nurcihan Aygun1, Yalin Iscan2, Murat Ozdemir3, Selen Soylu4, Oguz Ugur Aydin5, Ismail Cem Sormaz2, Ahmet Cem Dural6, Nuri Alper Sahbaz6, Serkan Teksoz7, Ozer Makay3, Ali Ugur Emre5, Mehmet Haciyanli8, Recep Gokhan Icoz3, Yasemin Giles2, Adnan Isgor9, Mehmet Uludag1, Fatih Tunca2
1Department of Genaral Surgery, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Health Practice and Research Center, Istanbul, Turkey
2Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
3Department of General Surgery, Division of Endocrine Surgery, Ege University Faculty of Medicine, Izmir, Turkey
4Department of General Surgery, Malatya Dogansehir Training and Research Hospital, Malatya, Turkey
5Department of General Surgery, Division of Endocrine Surgery, Ankara Guven Hospital, Ankara, Turkey
6Department of General Surgery, University of Health Sciences, Istanbul Bakirkoy Dr. Sadi Konuk Health Practice and Research Center, Istanbul, Turkey
7Department of General Surgery, Division of Endocrine Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
8Department of General Surgery, IKCU Medical Faculty, Izmir, Turkey
9Department of General Surgery, Bahcesehir University Faculty of Medicine, Istanbul; Sisli Memorial Hospital, Istanbul, Turkey

The 2019 novel coronavirus disease (COVID-19) was initially seen in Wuhan, China, in December 2019. World Health Organization classified COVID-19 as a pandemic after its rapid spread worldwide in a few months. With the pandemic, all elective surgeries and non-emergency procedures have been postponed in our country, as in others. Most of the endocrine operations can be postponed for a certain period. However, it must be kept in mind that these patients also need surgical treatment, and the delay time should not cause a negative effect on the surgical outcome or disease process. It has recently been suggested that elective surgical interventions can 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 the immediate onset of the COVID-19 pandemic. We should know that these guidelines and recommendations are not meant to constitute a position statement, the standard of care, or evidence-based/best practice. However, these are mostly the opinions of a selected group of surgeons. Generally, only life-threatening emergency operations should be performed in the stage where the epidemic exceeds the capacity of the hospitals (first stage), cancer and transplantation surgery should be initiated when the outbreak begins to be controlled (second stage), and surgery for elective cases should be performed in a controlled manner with suppression 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 opinions by considering factors, such as the course and biology of the disease, rather than being evidence-based. In the recent reports of many endocrine surgery associations and in various reviews, it has been stated that most of the cases can be postponed to the third stage of the epidemic.
We aimed to evaluate the risk reduction strategies and recommendations that can help plan the surgery, prepare for surgery, protect both patients and healthcare workers during the operation and care for the patients in the postoperative period in endocrine surgery.

Keywords: COVID-19, endocrine surgery; pandemic.

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

Nurcihan Aygun1, Yalin Iscan2, Murat Ozdemir3, Selen Soylu4, Oguz Ugur Aydin5, Ismail Cem Sormaz2, Ahmet Cem Dural6, Nuri Alper Sahbaz6, Serkan Teksoz7, Ozer Makay3, Ali Ugur Emre5, Mehmet Haciyanli8, Recep Gokhan Icoz3, Yasemin Giles2, Adnan Isgor9, Mehmet Uludag1, Fatih Tunca2
1Department of Genaral Surgery, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Health Practice and Research Center, Istanbul, Turkey
2Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
3Department of General Surgery, Division of Endocrine Surgery, Ege University Faculty of Medicine, Izmir, Turkey
4Department of General Surgery, Malatya Dogansehir Training and Research Hospital, Malatya, Turkey
5Department of General Surgery, Division of Endocrine Surgery, Ankara Guven Hospital, Ankara, Turkey
6Department of General Surgery, University of Health Sciences, Istanbul Bakirkoy Dr. Sadi Konuk Health Practice and Research Center, Istanbul, Turkey
7Department of General Surgery, Division of Endocrine Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
8Department of General Surgery, IKCU Medical Faculty, Izmir, Turkey
9Department of General Surgery, Bahcesehir University Faculty of Medicine, Istanbul; Sisli Memorial Hospital, Istanbul, Turkey

The 2019 novel coronavirus disease (COVID-19) was initially seen in Wuhan, China, in December 2019. World Health Organization classified COVID-19 as a pandemic after its rapid spread worldwide in a few months. With the pandemic, all elective surgeries and non-emergency procedures have been postponed in our country, as in others. Most of the endocrine operations can be postponed for a certain period. However, it must be kept in mind that these patients also need surgical treatment, and the delay time should not cause a negative effect on the surgical outcome or disease process. It has recently been suggested that elective surgical interventions can 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 the immediate onset of the COVID-19 pandemic. We should know that these guidelines and recommendations are not meant to constitute a position statement, the standard of care, or evidence-based/best practice. However, these are mostly the opinions of a selected group of surgeons. Generally, only life-threatening emergency operations should be performed in the stage where the epidemic exceeds the capacity of the hospitals (first stage), cancer and transplantation surgery should be initiated when the outbreak begins to be controlled (second stage), and surgery for elective cases should be performed in a controlled manner with suppression 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 opinions by considering factors, such as the course and biology of the disease, rather than being evidence-based. In the recent reports of many endocrine surgery associations and in various reviews, it has been stated that most of the cases can be postponed to the third stage of the epidemic.
We aimed to evaluate the risk reduction strategies and recommendations that can help plan the surgery, prepare for surgery, protect both patients and healthcare workers during the operation and care for the patients in the postoperative period in endocrine surgery. (SETB-2020-05-084)

Anahtar Kelimeler: COVID-19, endocrine surgery; pandemic.

Nurcihan Aygun, Yalin Iscan, Murat Ozdemir, Selen Soylu, Oguz Ugur Aydin, Ismail Cem Sormaz, Ahmet Cem Dural, Nuri Alper Sahbaz, Serkan Teksoz, Ozer Makay, Ali Ugur Emre, Mehmet Haciyanli, Recep Gokhan Icoz, Yasemin Giles, Adnan Isgor, Mehmet Uludag, Fatih Tunca. Endocrine Surgery during the COVID-19 Pandemic: Recommendations from the Turkish Association of Endocrine Surgery. SETB. 2020; 54(2): 117-131

Corresponding Author: Nurcihan Aygun
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