Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
Eur J Cardiothorac Surg. 2020 Nov 1;58(5):991-996. doi: 10.1093/ejcts/ezaa324.
We reviewed the incidence of coronavirus disease 2019 cases and the postoperative outcomes of patients who had thoracic surgery during the beginning and at the highest point of transmission in our community.
We retrospectively reviewed patients who had undergone elective thoracic surgery from 12 February 2020 to 30 April 2020 and were symptomatic or tested positive for severe acute respiratory syndrome coronavirus 2 infection within 14 days after surgery, with a focus on their complications and potential deaths.
Out of 101 surgical procedures, including 57 primary oncological resections, 6 lung transplants and 18 emergency procedures, only 5 cases of coronavirus disease 2019 were identified, 3 in the immediate postoperative period and 2 as outpatients. All 5 patients had cancer; the median age was 64 years. The main virus-related symptom was fever (80%), and the median onset of coronavirus disease 2019 was 3 days. Although 80% of the patients who had positive test results for severe acute respiratory syndrome coronavirus 2 required in-hospital care, none of them were considered severe or critical and none died.
These results indicate that, in properly selected cases, with short preoperative in-hospital stays, strict isolation and infection control protocols, managed by a dedicated multidisciplinary team, a surgical procedure could be performed with a relatively low risk for the patient.
我们回顾了在社区传播初期和高峰期接受过胸部手术的患者的 2019 年冠状病毒病(COVID-19)病例发生率和术后结局。
我们回顾性分析了 2020 年 2 月 12 日至 4 月 30 日期间接受择期胸部手术且术后 14 天内出现严重急性呼吸综合征冠状病毒 2 感染症状或检测结果阳性的患者,重点关注其并发症和潜在死亡情况。
在 101 例手术中,包括 57 例原发性肿瘤切除术、6 例肺移植术和 18 例急症手术,仅发现 5 例 COVID-19 病例,3 例发生在术后即刻,2 例为门诊患者。所有 5 例患者均患有癌症;中位年龄为 64 岁。主要与病毒相关的症状是发热(80%),COVID-19 的中位发病时间为 3 天。尽管 80%的 SARS-CoV-2 检测结果阳性患者需要住院治疗,但均未被认为是重症或危重症,也无人死亡。
这些结果表明,在适当选择的病例中,术前住院时间短、严格的隔离和感染控制方案、由专门的多学科团队管理的情况下,手术的风险相对较低。