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    Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic

    5 May, 2020

    Surgical practice guidelines for colorectal cancer must be modified for the unprecedented COVID-19 pandemic as well as potential future outbreaks. Data to support delays in surgical care are limited. This review analyzes management recommendations and the strength of published evidence using the GRADE system to provide a rational basis for clinical decision-making.
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    Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home

    30 Apr, 2020

    Amidst the COVID-19 public health crisis, that has infected more than one million people in over 180 countries, the educational needs of surgical trainees should not be neglected. Promoting remote 
    learning platforms such as those highlighted in the review and integrating them into formal curriculum can expand educational opportunities beyond the walls of the hospital. Such measures may mitigate the diminished surgical skill among surgical trainees that is foreseeable in hospitals...
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    Changing the Paradigm of Surgical Research during a Pandemic

    28 Apr, 2020

    The rapidly evolving and progressing nature of the present COVID-19 pandemic has highlighted several critical limitations in the traditional model of surgical research; namely, the inability to provide timely evidence to rapidly inform and change clinical practice, thus ultimately defeating its main purpose of improving patient outcomes. The key question remains the same; ‘how do we deliver the best possible care for our patients?’ What has changed however is that the novel cont...
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    In Situ Simulation Enables Operating Room Agility in the COVID-19 Pandemic

    28 Apr, 2020

    Introduction

    As COVID-19 infections soar worldwide, surgical teams must quickly adapt to care for the COVID-19-positive patient in the operating room (OR). This challenge comes in the face of constant change in data and conditions, reliable evidence yet to emerge, shortages of personal protective equipment (PPE), uncertainty due to lack of testing equipment and capacity, and unprecedented strain on caregivers, hospital systems, and resources.


    Agility is essential not onl...
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    Maintaining Trauma Care Access During the COVID-19 Pandemic: an urban, Level-1 trauma center’s experience

    28 Apr, 2020

    Amidst the SARS-CoV-2 or “COVID-19” pandemic, the need for trauma care remains a critical public health responsibility. Anticipating augmentation of social determinants of violence, “end stage” presentations of surgical pathologies from delayed care, and demands on surgeons and surgical intensivists, readiness, adaptability, and leadership in trauma centers are paramount. This Surgical Perspectives centers around an urban, Level-1 trauma center’s experience in meeting the challenge to mai...
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    Prehabilitation telemedicine in neoadjuvant surgical oncology patients during the Novel COVID-19 Coronavirus Pandemic

    28 Apr, 2020

    In the setting of the novel COVID-19 pandemic, prehabilitation may support cancer patients who are receiving neoadjuvant therapy prior to anticipated surgery. Recommended “social distancing” among these immunocompromised patients may decrease their physical activity and increase the risk of cardiopulmonary deconditioning and sarcopenia, in addition to the psychosocial stress of a cancer diagnosis, predicted future surgery, and community withdrawal. The resultant cascade of physiologic and...
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    Operationalizing the Operating Room: Ensuring Appropriate Surgical Care in the Era of COVID-19

    28 Apr, 2020

    Abstract

    Over the past decade, most academic medical centers have experienced increasing demands for surgical services. In many instances, lack of capacity in the operating rooms has resulted in a back log of patients needing surgery. On March 12th, the World Health Organization declared COVID-19 as a worldwide pandemic. In the United States, in preparation for a surge in patients requiring hospitalization for COVID-19, national societies, including the American College of Surgeons...
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    Gastrointestinal Complications in Critically Ill Patients with COVID-19

    28 Apr, 2020

    Extra-pulmonary disease has been observed in patients with Coronavirus Disease 2019 (COVID-19). In this publication, the gastrointestinal (GI) complications of patients with severe COVID-19 admitted to the intensive care unit (ICU) at the Massachusetts General Hospital between March 13thand April 12th, 2020 are described. 

    During this time period, 141 patients were admitted to the ICU with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed by reve...
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    A combined approach to priorities of Surgical Oncology during the COVID-19 epidemic

    28 Apr, 2020

    The number of people infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has exponentially increased worldwide1 and Coronavirus disease 2019 (COVID-19) is officially a pandemic. On Feb 21th, 2020, the first person-to-person transmission was reported in Italy and since then the infection chain has led to one of the largest COVID-19 outbreaks outside Asia to date. All started and spread in the Lombardy region, the most populated region in Italy (10.2 million of i...
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    Global Survey on Pancreatic Surgery during the COVID-19 Pandemic

    28 Apr, 2020

    The World Health Organization (WHO) declared a pandemic of coronavirus disease (COVID-19) (SARS-CoV-2) on March 11, 2020.1 The rapid spread of COVID-19 infections heavily impacts health care systems worldwide, resulting in limitations in both hospital and intensive care unit (ICU) capacity. As a result, this pandemic not only affects COVID-19 patients, but strikes the entire health care system including the care for patients with pancreatic cancer and other pancreatic diseases.
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    What should I do?

    28 Apr, 2020
    This paper published in Annals of Surgery examines the conflicting obligations of a surgeon as he tries to decide whether to opt out of the care of Covid-19 patients. These obligations include duty to care, duty to society, duty to family, duty to co-workers, and duty to self. What should he do?