Gaston Czar Louie Lopez, Pag-Ong Johann Proceso, Dacanay Emilleo, Quintos Albert Jerome
Department of Orthopedics, Quirino Memorial Medical Center, Quezon City, Philippines
Department of Orthopedics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
BMJ Case Rep. 2020 Jul 8;13(7):e237197. doi: 10.1136/bcr-2020-237197.
A 17-year-old man with osteosarcoma of the proximal humerus was planned for possible limb salvage surgery after standard neoadjuvant chemotherapy. However, during the surgical phase of treatment, the COVID-19 or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak occurred changing the healthcare landscape due to uncertainty regarding the virus, risk of COVID-19 infection and complications, and implementation of an enhanced community quarantine restricting movement of people within cities. Instead of limb salvage surgery, the patient underwent a forequarter amputation. Exposure to the virus in a high-risk hospital setting was minimised with patient discharge after a short hospital stay and home convalescence monitored by video conferencing. Multidisciplinary sarcoma team meetings with family members and a sarcoma navigator nurse were crucial in managing expectations and deciding on appropriate treatment in the setting of a novel infectious disease causing a pandemic.
一名17岁的近端肱骨骨肉瘤男性患者,在接受标准新辅助化疗后计划进行保肢手术。然而,在治疗的手术阶段,新型冠状病毒肺炎(COVID-19)或严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫情爆发,由于病毒的不确定性、COVID-19感染及并发症风险,以及实施强化社区隔离限制城市内人员流动,改变了医疗格局。该患者未进行保肢手术,而是接受了前半侧截肢术。通过缩短住院时间并在出院后进行视频会议监测居家康复,将患者在高风险医院环境中接触病毒的情况降至最低。多学科肉瘤团队与家庭成员以及肉瘤导航护士进行的会议,对于在这种导致大流行的新型传染病背景下管理预期并决定适当治疗方案至关重要。