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