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2019年冠状病毒病大流行期间癌症手术的结果:持续癌症护理实践的准备情况

Outcomes of Cancer Surgery During the COVID-19 Pandemic: Preparedness to Practising Continuous Cancer Care.

作者信息

Ramachandra C, Sugoor Pavan, Karjol Uday, Arjunan Ravi, Altaf Syed, Halkud Rajshekar, Krishnappa R, Chavan Purushotham, Siddappa K T, Shetty Rathan, Pallavi V R, Rathod Praveen, Shobha K, Sabitha K S

机构信息

Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India.

Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 India.

出版信息

Indian J Surg Oncol. 2023 Jun;14(2):440-444. doi: 10.1007/s13193-020-01250-z. Epub 2020 Oct 19.

Abstract

The COVID-19 pandemic has placed unprecedented pressure on healthcare services. Deprioritisation of nonemergency clinical services and growing concerns of adverse outcomes of COVID-19 in cancer patients is having a deleterious impact across oncologic practice. We report cancer surgery outcomes taking into account the acuity of the COVID-19 situation. A prospectively maintained database of the Department of Surgical Oncology was analysed from 1st May to 30th June, 2020, to evaluate the perioperative outcomes, morbidity and mortality following major surgical procedures. A total of 359, preoperatively, tested negative for COVID-19 underwent surgery. Median age was 52 years with 26.7% ( = 96) above the age of 60 years. Sixty-one percent ( = 219) patients were American Society of Anaesthesiology grades II-III. As per surgical complexity grading, 36.8% ( = 132) cases were lower grades (I-III) and 63.2% ( = 227) were complex surgeries (IV-VI). 5.3% ( = 19) had ≥ grade III Clavien-Dindo complication, and the postoperative mortality rate was 0.27% ( = 1). Major complication rates in patients > 60 years were 9.3% in comparison to 4.1% in < 60 years ( = 0·63). The median hospital stay was 1-10 days across subspecialties. Postoperatively, repeat COVID 19 testing in 2 suspected patients were negative. Our study showed that after screening, triaging and prioritisation, asymptomatic cases may undergo cancer surgeries without increased morbidity during COVID-19 pandemic.

摘要

新冠疫情给医疗服务带来了前所未有的压力。非紧急临床服务的优先级降低,以及癌症患者中对新冠不良后果的日益担忧,正在对肿瘤学实践产生有害影响。我们报告了考虑到新冠疫情严重程度的癌症手术结果。对2020年5月1日至6月30日外科肿瘤学系前瞻性维护的数据库进行分析,以评估大手术围手术期结果、发病率和死亡率。共有359例术前新冠检测呈阴性的患者接受了手术。中位年龄为52岁,60岁以上的患者占26.7%(n = 96)。61%(n = 219)的患者为美国麻醉医师协会II - III级。根据手术复杂程度分级,36.8%(n = 132)的病例为较低级别(I - III级),63.2%(n = 227)为复杂手术(IV - VI级)。5.3%(n = 19)发生了≥III级Clavien - Dindo并发症,术后死亡率为0.27%(n = 1)。60岁以上患者的主要并发症发生率为9.3%,而60岁以下患者为4.1%(p = 0.63)。各亚专业的中位住院时间为1 - 10天。术后,2例疑似患者的新冠病毒复测结果为阴性。我们的研究表明,在进行筛查、分诊和优先级排序后,无症状病例在新冠疫情期间可进行癌症手术,且发病率不会增加。

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IASO COVID-19 Guidelines (Updated on 9th April 2020).国际外科手术协会(IASO)新冠病毒病指南(2020年4月9日更新)
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COVID-19: global consequences for oncology.新型冠状病毒肺炎:对肿瘤学的全球影响。
Lancet Oncol. 2020 Apr;21(4):467. doi: 10.1016/S1470-2045(20)30175-3.
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