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Aygun N, Iscan Y, Ozdemir M, Soylu S, Aydin OU, Sormaz IC, Dural AC, Sahbaz NA, Teksoz S, Makay O, Emre AU, Haciyanli M, Icoz RG, Giles Y, Isgor A, Uludag M, Tunca F. Endocrine Surgery during the COVID-19 Pandemic: Recommendations from the Turkish Association of Endocrine Surgery. Sisli Etfal Hastan Tip Bul 2020; 54:117-131. [PMID: 32617048 PMCID: PMC7326680 DOI: 10.14744/semb.2020.65902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Nurcihan Aygun
- Department of Genaral Surgery, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Health Practice and Research Center, Istanbul, Turkey
| | - Yalin Iscan
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Murat Ozdemir
- Department of General Surgery, Division of Endocrine Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Selen Soylu
- Department of General Surgery, Malatya Dogansehir Training and Research Hospital, Malatya, Turkey
| | - Oguz Ugur Aydin
- Department of General Surgery, Division of Endocrine Surgery, Ankara Guven Hospital, Ankara, Turkey
| | - Ismail Cem Sormaz
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Cem Dural
- Department of General Surgery, University of Health Sciences, Istanbul Bakirkoy Dr. Sadi Konuk Health Practice and Research Center, Istanbul, Turkey
| | - Nuri Alper Sahbaz
- Department of General Surgery, University of Health Sciences, Istanbul Bakirkoy Dr. Sadi Konuk Health Practice and Research Center, Istanbul, Turkey
| | - Serkan Teksoz
- Department of General Surgery, Division of Endocrine Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Ozer Makay
- Department of General Surgery, Division of Endocrine Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ali Ugur Emre
- Department of General Surgery, Division of Endocrine Surgery, Ankara Guven Hospital, Ankara, Turkey
| | - Mehmet Haciyanli
- Department of General Surgery, IKCU Medical Faculty, Izmir, Turkey
| | - Recep Gokhan Icoz
- Department of General Surgery, Division of Endocrine Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Yasemin Giles
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Adnan Isgor
- Department of General Surgery, Bahcesehir University Faculty of Medicine, Istanbul; Sisli Memorial Hospital, Istanbul, Turkey
| | - Mehmet Uludag
- Department of Genaral Surgery, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Health Practice and Research Center, Istanbul, Turkey
| | - Fatih Tunca
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Acar T, Ozbek SS, Ertan Y, Kavukcu G, Tuncyurek M, Icoz RG, Akyildiz MM, Makay O, Acar S. Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign. Med Ultrason 2015; 17:139-146. [PMID: 26052562 DOI: 10.11152/mu.2013.2066.172.tka] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIMS To review the detailed gray-scale and Doppler ultrasonography features of histologically proven parathyroid adenomas (PAs) evaluated with high-end ultrasonography devices and to present a novel ultrasonography finding called the dual concentric echo sign in PA with histopathologic correlation which was encountered during detailed analysis. MATERIAL AND METHODS Fifty-six PAs with histopathological result were enrolled. The longest dimension, shape, distance to skin surface, internal echo and Doppler US features obtained with high-end US devices were evaluated. RESULTS PAs had variable range of shape including oval, irregular, fusiform, lobulated, crescent-shaped, and nodular configuration. In nine patients the lesions were shown to have cystic components and calcifications were seen in four cases. Dual concentric echo sign was detected in 18% PAs. Histological reevaluation of this subgroup demonstrated significantly increased edema (p<0.01), and ectatic vessels (p=0.02) in the central part of the lesion compared to the rest of the PAs. CONCLUSIONS The results of the study led to the conclusion that PAs have variable gray-scale and Doppler findings. Typical sonographic features like ovoid shape, homogeneously hypoechoic pattern may not be present in all PAs. Dual concentric echo sign which is a novel sonographic pattern may be suggestive of a PA.
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Affiliation(s)
- Turker Acar
- Department of Radiology, Mevlana University School of Medicine, Konya, Turkey.
| | - Suha Sureyya Ozbek
- Department of Radiology, Ege University School of Medicine, Izmir, Turkey
| | - Yesim Ertan
- Department of Pathology, Ege University School of Medicine, Izmir, Turkey
| | - Gulgun Kavukcu
- Department of Radiology, Ege University School of Medicine, Izmir, Turkey
| | - Muge Tuncyurek
- Department of Pathology, Ege University School of Medicine, Izmir, Turkey
| | - Recep Gokhan Icoz
- Department of Surgery, Ege University School of Medicine, Izmir, Turkey
| | | | - Ozer Makay
- Department of Surgery, Ege University School of Medicine, Izmir, Turkey
| | - Seval Acar
- Department of Family Medicine, Tepecik Education and Training Hospital, Izmir, Turkey
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