Comment on: “Consensus of the major outpatient surgery section of the Spanish Association of Surgeons on the role of major outpatient surgery in the SARS-CoV-2 pandemic”

Dear Editor:

We have read with great interest the article recently published by Morales-García et al.¹, on “Consensus of the major ambulatory surgery section of the Spanish Association of Surgeons on the role of major ambulatory surgery in the SARS-CoV-2 pandemic”, where they demonstrate the great importance of major ambulatory surgery, which was strongly affected by the SARS-CoV-2 pandemic. They also provide detailed guidance on how these procedures should be restarted and managed in times of pandemic. For this reason, we would like to add a few comments on the current situation regarding this type of procedure in Latin American countries, and more specifically in Colombia.

Annually, 234 million major surgical procedures are performed worldwide, which is equivalent to one procedure for every 25 people. Acute abdominal diseases are the most frequent, reportedly accounting for approximately 10% of emergency department consultations and the highest number of admissions and surgical interventions.²

According to the World Health Organisation (WHO), cancer causes 10 million deaths a year. About 70% of cancer deaths occur in low- and middle-income countries. The total cost attributable to the disease in 2010 amounted to 1.16 trillion US dollars.³

In Colombia, neoplasms are one of the three leading causes of death. Between 2005 and 2013, malignant tumours of the digestive organs and peritoneum, except stomach and colon, accounted for 15.08% of all deaths. The incidence of cancer in the period 2007–2011 was approximately 62,818 cases.⁴

Given the above context, we are aware of the need and importance of performing major surgical procedures. However, nationally no guidance that focuses on the problem and dictates generalised parameters is available. Although each health institution at a national level has developed consensus and management guides, a guideline issued by the scientific associations of each speciality is always important.⁵

In addition, we consider it extremely important to implement strategies such as the “Single Act Consultation”, which was used in times of pandemic to reduce exposure to possible COVID-19 infection, but could be a strategy that will remain in place over time, as it is able to offer comprehensive, agile and comfortable management for the patient.

Finally, we would like to thank the authors for these management of major ambulatory surgery guidelines, and consider the need to replicate these guidelines nationally in order to optimise the scheduling of patients requiring such procedures, which, when performed, will have an effect on decreasing morbidity and mortality rates.