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Review
. 2020 Jun;157(3S1):S43-S49.
doi: 10.1016/j.jviscsurg.2020.04.018. Epub 2020 Apr 30.

Endocrine surgery during and after the COVID-19 epidemic: Expert guidelines from AFCE

G Baud  1 , L Brunaud  2 , J-C Lifante  3 , C Tresallet  4 , F Sebag  5 , J-P Bizard  6 , M Mathonnet  7 , F Menegaux  8 , R Caiazzo  1 , E Mirallié  9 , F Pattou  10 ; AFCE COVID Study Group
Affiliations
Review

Endocrine surgery during and after the COVID-19 epidemic: Expert guidelines from AFCE

G Baud et al. J Visc Surg. 2020 Jun.

Abstract

The COVID-19 pandemic commands a major reorganisation of the entire French healthcare system. In France, general rules have been issued nationally and implemented by each healthcare centre, both public and private, throughout France. Guidelines drafted by an expert group led by the French-speaking Association of Endocrine Surgery (AFCE) propose specific surgical management principles for thyroid, parathyroid, endocrine pancreas and adrenal surgery during and after the COVID-19 epidemic.

Keywords: Adrenal; COVID-19; Coronavirus; Endocrine surgery; Neuroendocrine tumour; Parathyroid; Thyroid.

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Figures

Figure 1
Figure 1
General principles for scheduling endocrine surgery during and after the COVID-19 epidemic.
Figure 2
Figure 2
Principles for scheduling thyroid cancers during and after the COVID-19 epidemic. * Loco-regional aggressiveness defined as the presence of recurrent nerve paralysis, local invasion with esophageal, vascular or tracheal involvement, or massive ganglion infiltration. (Anapl = anaplastic, Lymph: lymphoma; MDT: multidisciplinary team).
Figure 3
Figure 3
Principles for scheduling surgery for benign thyroid disorders during and after the COVID-19 epidemic. * Synthetic anti-thyroid agents, lithium, potassium perchlorate, plasmapheresis. (Med TTT = medical treatment).
Figure 4
Figure 4
Principles for scheduling parathyroid surgery during and after the COVID-19 epidemic. Blood calcium > 3.5 mmol/L and/or presence of clinical complications (acute pancreatitis secondary to HPT, brown tumour, calciphylaxis fracture osteopenia, cardiac rhythm disorder with heart failure). * Hydration, calcimimetic (Med TTT = medical treatment).
Figure 5
Figure 5
Principles for scheduling surgery for neuroendocrine tumours of the pancreas during and after the COVID-19 epidemic. * Diazoxide, proton pump inhibitor, somatostatin analogues, (TTT med: medical treatment; MDT: multidisciplinary team).
Figure 6
Figure 6
Principles for scheduling surgery for adrenal tumours during and after the COVID-19 epidemic. * Steroidogenesis inhibitors (metyrapone, ketoconazole), anti-hypertensive agents (alpha-blocking drugs, beta-blocking drugs, calcium inhibitors), anti-aldosterone diuretics, (Med TTT:medical treatment, pheochr: pheochromocytoma; MDT: multidisciplinary team).
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