A systematic review of viral transmission risk to healthcare staff comparing laparoscopic and open surgery

Abstract Introduction Aerosol generating procedures such as laparoscopic surgery are known to be associated with increased risks of viral transmission to the healthcare workers. The safety of laparoscopy during the COVID-19 pandemic was therefore debated. We aimed to systematically review the literature regarding the safe use of laparoscopy during COVID-19. Method We performed a systematic search using PubMed and ScienceDirect databases from inception to 1st May 2020. The following search terms were used: ‘’laparoscopic surgery and COVID-19’’; ‘’minimally invasive surgery and COVID-19’’. The study protocol was registered with PROSPERO register. Results Altogether, 174 relevant citations were identiﬁed and reviewed for this study, of which 22 articles were included. The analysis of the findings was presented in tabular form. We scrutinized the common recommendations for performing laparoscopy during the COVID-19 pandemic in forms of pre-, intra- and postoperative phases. Conclusions There is no scientific evidence to date for the transmission of COVID-19 by means of laparoscopic surgery. If safe, conservative management is the primary alternative during the pandemic. If indicated, laparoscopic surgery can be used with precautions because of supplementary benefits compared to open surgery. We concluded that recommended precautions should be respected while performing laparoscopy during the pandemic.

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Systematic Review Comparing Open versus Endoscopic Surgery in Clival Chordomas and a 10-Year Single-Center Experience

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1722933 ◽

2021 ◽

Author(s):

Ravindran Visagan ◽

Asfand Baig Mirza ◽

Mohamed Okasha ◽

Timothy Martyn Boardman ◽

Eleni Maratos ◽

...

Keyword(s):

Systematic Review ◽

Surgical Management ◽

Open Surgery ◽

Literature Search ◽

Optimal Management ◽

Total Resection ◽

Single Center Experience ◽

Institutional Experience ◽

Open Versus ◽

Slow Growing

Abstract Objectives Chordomas are rare, slow-growing, and osteo-destructive tumors of the primitive notochord. There is still contention in the literature as to the optimal management of chordoma. We conducted a systematic review of the surgical management of chordoma along with our 10-year institutional experience. Design A systematic search of the literature was performed in October 2020 by using MEDLINE and EMBASE for articles relating to the surgical management of clival chordomas. We also searched for all adult patients surgically treated for primary clival chordomas at our institute between 2009 and 2019. Participants Only articles describing chordomas arising from the clivus were included in the analysis. For our institution experience, only adult primary clival chordoma cases were included. Main Outcome Measures Patients were divided into endoscopic or open surgery. Rate of gross total resection (GTR), recurrence, and complications were measured. Results Our literature search yielded 24 articles to include in the study. Mean GTR rate among endoscopic cases was 51.9% versus 41.7% for open surgery. Among the eight cases in our institutional experience, we found similar GTR rates between endoscopic and open surgery. Conclusion Although there is clear evidence in the literature that endoscopic approaches provide better rates of GTR with fewer overall complications compared to open surgery. However, there are still situations where endoscopy is not viable, and thus, open surgery should still be considered if required.

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Surgical and Endovascular Management of Isolated Internal Iliac Artery Aneurysms: A Systematic Review and Meta-Analysis

Vascular and Endovascular Surgery ◽

10.1177/1538574420981812 ◽

2020 ◽

pp. 153857442098181

Author(s):

Paolo Perini ◽

Erica Mariani ◽

Mara Fanelli ◽

Alessandro Ucci ◽

Giulia Rossi ◽

...

Keyword(s):

Systematic Review ◽

Iliac Artery ◽

Endovascular Repair ◽

Open Surgery ◽

Internal Iliac Artery ◽

Cochrane Library ◽

Hypogastric Artery ◽

Stent Grafting ◽

Buttock Claudication ◽

Internal Iliac

Objectives: The purpose of this paper is to report the different modalities for the treatment of isolated internal iliac artery aneurysms (IIIAA), as well as their outcomes. Methods: We performed a systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library; last search: April 2020). We included articles reporting on the outcomes for IIIAA interventions comprising at least 5 patients. Studies were included when presenting extractable outcome data regarding intraoperative and/or early results. We performed meta-analyses of proportions for different outcomes, using random effects model. Results: Thirteen non-randomized studies were included (192 patients with 202 IIIAA). IIIAA were symptomatic in the 18.1% (95%CI 9.3-26.9; I2 54.46%, P = .019). Estimated mean IIIAA diameter was 46.28 mm (95%CI 39.72-52.85; I2 88.85%, P < .001). Open repair was performed in 21/202 cases. Endovascular treatments were: embolization (81/181), embolization and hypogastric artery coverage (79/181), hypogastric artery coverage by stent-grafting (15/181), stent-grafting in the hypogastric artery (6/181). Overall estimated technical success (TS) rate was 91.6% (95% CI 86.8-95.5; I2 45.82%, P = .031). TS rate was 94.5% for open surgery (95%CI 85.3-100; I2 0%, P = .907), and 89.7% for endovascular repair (95%CI 83.8-95.6; I2 55.43%, P = .006). Estimated overall 30-day mortality was 3.1% (95%CI 0.8-5.4; I2 0%, P = .969). Mortality rates after open surgery and endovascular repair were 8.2% (95%CI 3.4-19.8; I2 0%, P = .545) and 2.8% (95%CI 0.5-5.1; I2 0%, P = .994), respectively. Estimated mean follow-up was 32.63 months (95%CI 21.74-43.53; I2 94.45%, P < .001). During this timeframe, IIIAA exclusion was preserved in 92.8% of the patients (95%CI 89.3-96.2; I2 0%, P = .797). Buttock claudication occurred in 13.9% of the patients (95%CI 8.7-19.2; I2 0%, P = .622). Conclusions: IIIAA are frequently large, and symptomatic at presentation. Several treatments are proposed in literature, open and endovascular, both with good results. The endovascular treatment is the preferred method of treatment in literature, since it offers good short- to mid-term results and low early mortality. Buttock claudication after hypogastric artery exclusion is a common complication.

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A knowledge gap unmasked: viral transmission in surgical smoke: a systematic review

Surgical Endoscopy ◽

10.1007/s00464-020-08261-5 ◽

2021 ◽

Author(s):

Connal Robertson-More ◽

Ted Wu

Keyword(s):

Systematic Review ◽

Viral Transmission ◽

Knowledge Gap ◽

Surgical Smoke

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Non-surgical complications after laparoscopic and open surgery for colorectal cancer − A systematic review of randomised controlled trials

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2015.04.007 ◽

2015 ◽

Vol 41 (9) ◽

pp. 1118-1127 ◽

Cited By ~ 24

Author(s):

A.H.W. Schiphorst ◽

N.M. Verweij ◽

A. Pronk ◽

I.H.M. Borel Rinkes ◽

M.E. Hamaker

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Surgical Complications ◽

Randomised Controlled Trials ◽

Open Surgery ◽

Controlled Trials ◽

Randomised Controlled

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Organisation-wide interventions to promote the health and well-being of healthcare staff during periods of increased demand: a systematic review

10.3310/hsdr-tr-132944 ◽

2021 ◽

Author(s):

Susan Baxter ◽

◽

Duncan Chambers ◽

Lindsay Blank ◽

Anna Cantrell ◽

...

Keyword(s):

Systematic Review ◽

Well Being ◽

Healthcare Staff ◽

Health And Well Being

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Risk assessment for long and short range airborne transmission of SARS-CoV-2, indoors and outdoors, using carbon dioxide measurements.

10.1101/2021.05.04.21256352 ◽

2021 ◽

Author(s):

Florian Poydenot ◽

Ismael Abdourahamane ◽

Elsa Caplain ◽

Samuel Der ◽

Jacques Haiech ◽

...

Keyword(s):

Public Health ◽

Health Policy ◽

Public Health Policy ◽

Short Range ◽

Epidemiological Data ◽

Public Spaces ◽

Viral Transmission ◽

Transmission Risk ◽

Reproduction Rate ◽

Airborne Transmission

A quantitative analysis of the viral transmission risk in public spaces al- lows us to identify the dominant mechanisms that a proactive public health policy can act upon to reduce risk, and to evaluate the reduction of risk that can be obtained. The contribution of public spaces to the propa- gation of SARS-CoV-2 can be reduced to a level necessary for a declining epidemic, i.e. an overall reproduction rate below one. Here, we revisit the quantitative assessment of indoor and outdoor transmission risk. We show that the long-range aerosol transmission is controlled by the flow rate of fresh air and by the mask filtering quality, and is quantitatively re- lated to the CO2 concentration, regardless the room volume and the num- ber of people. The short-range airborne transmission is investigated ex- perimentally using dedicated dispersion experiments performed in two shopping malls. Exhaled aerosols are dispersed by turbulent draughts in a cone, leading to a concentration inversely proportional to the squared dis- tance and to the flow velocity. We show that the average infection dose, called the viral quantum, can be determined from epidemiological data in a manner consistent with biological experimental data. Practical implications. The results provide quantitative guidance useful for making rational public health policy decisions to prevent the dominant routes of viral transmission through reinforced ventilation, air purification, mechanical dispersion using fans, and incentivizing the wear- ing of correctly fitted, quality facial masks (surgical masks, possibly cov- ered by another fabric mask, or non-medical FFP2 masks). Taken to- gether, such measures significantly reduce the airborne transmission risk of SARS-CoV-2.

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SARS-CoV-2 circulation in the school setting: A systematic review and meta-analysis

10.1101/2021.09.03.21263088 ◽

2021 ◽

Author(s):

Chiara Martinoli ◽

Carlo La Vecchia ◽

Sara Raimondi ◽

Federica Bellerba ◽

Clementina Sasso ◽

...

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Meta Analysis ◽

School Setting ◽

Viral Transmission ◽

Contact Tracing ◽

Random Effects Models ◽

Viral Spread ◽

Literature Searches ◽

Index Cases

Background. The contribution of children to viral spread in schools is still under debate. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Methods: Literature searches from April, 2021 and repeated on May, 15th 2021 yielded a total of 1088 publications: screening, contact tracing and seroprevalence studies. MOOSE guidelines were followed and data analyzed using random-effects models. Results: From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% Confidence Interval [CI] 0.05-0.81%) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%; 95%CI 0.76-5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (Odds Ratio [OR]=0.26; 95%CI 0.11-0.63) and were less susceptible to infection (OR=0.60; 95% CI 0.25-1.47). Finally, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children are 43% significantly less likely than adults to test positive for antibodies (OR=0.57; 95%CI: 0.49-0.68). In conclusion, testing all subjects in schools, independently of symptoms, students less likely than adults favor viral spread and SARS-CoV-2 circulation in schools was found to be limited.

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