Department of Urology, University College London Hospital NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK.
Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.
Int J Surg. 2020 Dec;84:57-65. doi: 10.1016/j.ijsu.2020.10.019. Epub 2020 Oct 24.
Two million non-emergency surgeries are being cancelled globally every week due to the COVID-19 pandemic, which will have a major impact on patients and healthcare systems.
During the peak of the pandemic in the United Kingdom, we set up a multicentre cancer network amongst 14 National Health Service institutions, performing urological, thoracic, gynaecological and general surgical urgent and cancer operations at a central COVID-19 cold site. This is a cohort study of 500 consecutive patients undergoing surgery in this network. The primary outcome was 30-day mortality from COVID-19. Secondary outcomes included all-cause mortality and post-operative complications at 30-days.
500 patients underwent surgery with median age 62.5 (IQR 51-71). 65% were male, 60% had a known diagnosis of cancer and 61% of surgeries were considered complex or major. No patient died from COVID-19 at 30-days. 30-day all-cause mortality was 3/500 (1%). 10 (2%) patients were diagnosed with COVID-19, 4 (1%) with confirmed laboratory diagnosis and 6 (1%) with probable COVID-19. 33/500 (7%) of patients developed Clavien-Dindo grade 3 or higher complications, with 1/33 (3%) occurring in a patient with COVID-19.
It is safe to continue cancer and urgent surgery during the COVID-19 pandemic with appropriate service reconfiguration.
由于 COVID-19 大流行，每周有 200 万非紧急手术被取消，这将对患者和医疗保健系统产生重大影响。
在英国大流行高峰期，我们在 14 个国民保健服务机构之间建立了一个多中心癌症网络，在中央 COVID-19 冷点进行泌尿外科、胸外科、妇科和普通外科的紧急和癌症手术。这是一项对该网络中连续 500 例手术患者进行的队列研究。主要结局是 COVID-19 30 天死亡率。次要结局包括 30 天内的全因死亡率和术后并发症。
500 例患者接受了手术，中位年龄为 62.5（IQR 51-71）。65%为男性，60%有已知癌症诊断，61%的手术被认为复杂或主要。没有患者在 30 天内因 COVID-19 死亡。30 天全因死亡率为 3/500（1%）。10 例（2%）患者被诊断为 COVID-19，4 例（1%）有确诊的实验室诊断，6 例（1%）可能患有 COVID-19。500 例患者中有 33 例（7%）发生了 Clavien-Dindo 分级 3 或更高的并发症，其中 1 例（3%）发生在 COVID-19 患者中。
在 COVID-19 大流行期间，通过适当的服务重新配置，继续进行癌症和紧急手术是安全的。
