Surgical cancer care in the COVID-19 era: front line views and consensus.

Pinheiro, Rodrigo Nascimento; Coimbra, Felipe J F; Costa-Jr, Wilson Luiz DA; Ribeiro, Heber Salvador DE Castro; Ribeiro, Reitan; Wainstein, Alberto Julius Alves; Laporte, Gustavo Andreazza; Coelho-Jr, Manoel Jesus Pinheiro; Fernandes, Paulo Henrique DE Sousa; Cordeiro, Eduardo Zanella; Sarmento, Bruno JosÉ Queiroz; Guimaraes-Filho, Marco Antonio C; Anghinoni, Marciano; Baiocchi, Glauco; Oliveira, Alexandre Ferreira

OBJECTIVE to suggest a script for surgical oncology assistance in COVID-19 pandemic in Brazil. METHOD a narrative review and a "brainstorming" consensus were carried out after discussion with more than 350 Brazilian specialists and renowned surgeons from Portugal, France, Italy and United States of America. RESULTS consensus on testing for COVID-19: 1- All patients to be operated should be tested between 24 and 48 before the procedure; 2- The team that has contact with sick or symptomatic patients should be tested; 3 - Chest tomography was suggested to investigate pulmonary changes. Consensus on protection of care teams: 1 - Use of surgical masks inside the hospitals. Use of N95 masks for all professionals in the operating room; 2 - Selection of cases for minimally invasive surgery and maximum pneumoperitoneal aspiration before removal of the surgical specimen; 2 - Optimization of the number of people in teams, with a minimum number of professionals, reducing their occupational exposure, the consumption of protective equipment and the circulation of people in the hospital environment; 3 - Isolation of contaminated patients. Priority consensus: 1- Construction of service priorities; 2 - Interdisciplinary discussion on minimally invasive or conventional pathways. CONCLUSION the Brazilian Society of Surgical Oncology (BSSO) suggests a script for coping with oncological treatment, remembering that the impoundment in the assistance of these cases, can configure a new wave of overload in health systems.