Abstract：
Introduction: The novel coronavirus disease (COVID-19) pandemic has had a significant impact on the care of patients with urolithiasis. Recommendations and prioritization of endourologic surgical procedures vary among regions, and a comprehensive overall international directive is needed. We used the Delphi method to obtain international consensus on managing urolithiasis patients during the pandemic. Methods: A three-round Delphi process was used to elicit expert consensus (53 global key opinion leaders within the Endourological Society from 36 countries) on an extensive survey on management of endourologic patients in a pandemic. Questions addressed general management, inpatient and outpatient procedures, clinic visits, follow-up care, and best practices for suspension and resumption of routine care. Results: Consensus was achieved in 64/84 (76%) questions. Key consensus findings included the following: consultations should be delivered remotely when possible. Invasive surgical procedures for urolithiasis patients should be reserved for high-risk situations (infection, renal failure, etc.). To prevent aerosolization, spinal anesthesia is preferred over general, whenever feasible. Treatment of asymptomatic renal stones should be deferred. Primary definitive treatment of obstructing or symptomatic stones (both renal and ureteral) is preferred over temporizing drainage. Extracorporeal shockwave lithotripsy should be continued for obstructive ureteral stones. There was consensus on treatment modalities and drainage strategies depending on location and size of the stone. Conclusion: International endourologist members of the Endourological Society participated in this Delphi initiative to provide expert consensus on management of urolithiasis during a pandemic. These results can be applied currently and during a future pandemic.
摘要：
简介：新型冠状病毒病（COVID-19）大流行对尿石症患者的护理产生了重大影响。不同地区的腔内外科手术的建议和优先次序各不相同，需要一个全面的总体国际指令。我们使用Delphi方法在大流行期间管理尿石症患者方面获得了国际共识。方法：采用三轮Delphi程序，就大流行中的泌尿科患者的管理进行广泛调查，以引起专家共识（来自36个国家的EndourologicalSociety的53位全球主要意见领袖）。关于一般管理的问题，住院和门诊程序，诊所就诊,后续护理,以及暂停和恢复常规护理的最佳做法。结果：在64/84（76％）的问题中达成了共识。主要的共识结果包括：磋商应尽可能远程进行。尿石症患者的侵入性外科手术应保留用于高风险情况（感染，肾功能衰竭,等。).为了防止雾化，脊髓麻醉优于一般麻醉，只要可行。无症状肾结石的治疗应推迟。对梗阻或有症状的结石（肾和输尿管）的主要确定性治疗优于临时引流。对于梗阻性输尿管结石，应继续进行体外冲击波碎石术。根据结石的位置和大小，对治疗方式和排水策略达成了共识。结论：泌尿外科学会的国际泌尿外科医师成员参加了这项Delphi倡议，以就大流行期间的尿石症管理提供专家共识。这些结果可以在当前和未来的大流行期间应用。
