de Santiago Javier, Yelo Carmen, F Chereguini Maria, Conde Ana, Galipienzo Javier, Salvatierra David, Linero Manuel, Alonso Sonsoles
Gynecology, MD Anderson Cancer Center Madrid, Madrid, Spain.
Gynecology, MD Anderson Cancer Center Madrid, Madrid, Spain
Int J Gynecol Cancer. 2020 Aug;30(8):1108-1112. doi: 10.1136/ijgc-2020-001638. Epub 2020 Jul 7.
OBJECTIVES: While numerous medical facilities have been forced to suspend oncological surgery due to system overload, debate has emerged on using non-surgical options on cancer cases during the pandemic. The goal of our study was to analyze, in a retrospective cohort study, the results of gynecological cancer surgery and evaluate postoperative complications in a single center in one of the most affected areas in Europe. METHODS: We retrospectively analyzed the records of patients who were referred between March 2020 and May 2020 for primary surgical treatment of breast, endometrial, ovarian, cervical, or vulvar cancer. RESULTS: The study included a total of 126 patients. Median age was 60 years (range 29-89). Patients were referred with breast (76/126, 60.3%), endometrial (29/126, 23%), ovarian (14/126, 11.1%), cervical (5/126, 4%), or vulvar cancer (2/126, 1.6%). Polymerase chain reaction (PCR) test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) was only conducted in 50% of cases due to the low availability of tests during the first phase of our study, and was indicated only in suspected cases according to the healthcare authorities' protocol. Median hospital stay was 1 day (range 0-18). Excluding breast surgery, laparoscopy was the most used procedure (43/126, 34.1%). 15 patients had a postoperative complication (15/126, 11.9%); only in 2 patients (2/15 13.3%) were there reports of Clavien-Dindo grade 3 or 4 complications. 6 patients tested positive for COVID-19 following a PCR diagnostic test, and these surgeries were cancelled. CONCLUSIONS: Adequate protective measures in the setting of COVID-19 free institutions enabled the continuity of cancer surgery without significant compromise of the safety of patients or healthcare workers.
目的:由于系统负荷过重,许多医疗机构被迫暂停肿瘤外科手术,因此在疫情期间对于癌症病例采用非手术治疗方案引发了争论。我们研究的目的是通过一项回顾性队列研究,分析欧洲受影响最严重地区之一的一个单一中心的妇科癌症手术结果,并评估术后并发症。 方法:我们回顾性分析了2020年3月至2020年5月期间因乳腺癌、子宫内膜癌、卵巢癌、宫颈癌或外阴癌接受初次手术治疗而转诊的患者记录。 结果:该研究共纳入126例患者。中位年龄为60岁(范围29 - 89岁)。患者所患癌症类型为乳腺癌(76/126,60.3%)、子宫内膜癌(29/126,23%)、卵巢癌(14/126,11.1%)、宫颈癌(5/126,4%)或外阴癌(2/126,1.6%)。由于在我们研究的第一阶段检测试剂供应不足,仅50%的病例进行了用于检测严重急性呼吸综合征冠状病毒2(SARS - COV - 2)的聚合酶链反应(PCR)检测,且仅根据卫生当局的方案在疑似病例中进行检测。中位住院时间为1天(范围0 - 18天)。除乳腺手术外,腹腔镜手术是最常用的手术方式(43/126,34.1%)。15例患者出现术后并发症(15/126,11.9%);仅有2例患者(2/15,13.3%)报告出现Clavien - Dindo 3级或4级并发症。6例患者经PCR诊断检测后COVID - 19呈阳性,这些手术被取消。 结论:在无COVID - 19的机构中采取适当的防护措施能够使癌症手术得以持续进行,而不会对患者或医护人员的安全造成重大影响。
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