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COVID-19 大流行期间肺癌手术中患者和医务人员的安全。

Safety of patients and providers in lung cancer surgery during the COVID-19 pandemic.

机构信息

Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY, USA.

Division of Medical Oncology, Department of Medicine, New York University Langone Health, New York, NY, USA.

出版信息

Eur J Cardiothorac Surg. 2020 Dec 1;58(6):1222-1227. doi: 10.1093/ejcts/ezaa332.

Abstract

OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has resulted in patient reluctance to seek care due to fear of contracting the virus, especially in New York City which was the epicentre during the surge. The primary objectives of this study are to evaluate the safety of patients who have undergone pulmonary resection for lung cancer as well as provider safety, using COVID-19 testing, symptoms and early patient outcomes.

METHODS

Patients with confirmed or suspected pulmonary malignancy who underwent resection from 13 March to 4 May 2020 were retrospectively reviewed.

RESULTS

Between 13 March and 4 May 2020, 2087 COVID-19 patients were admitted, with a median daily census of 299, to one of our Manhattan campuses (80% of hospital capacity). During this time, 21 patients (median age 72 years) out of 45 eligible surgical candidates underwent pulmonary resection-13 lobectomies, 6 segmentectomies and 2 pneumonectomies were performed by the same providers who were caring for COVID-19 patients. None of the patients developed major complications, 5 had minor complications, and the median length of hospital stay was 2 days. No previously COVID-19-negative patient (n = 20/21) or healthcare provider (n = 9: 3 surgeons, 3 surgical assistants, 3 anaesthesiologists) developed symptoms of or tested positive for COVID-19.

CONCLUSIONS

Pulmonary resection for lung cancer is safe in selected patients, even when performed by providers who care for COVID-19 patients in a hospital with a large COVID-19 census. None of our patients or providers developed symptoms of COVID-19 and no patient experienced major morbidity or mortality.

摘要

目的

2019 年冠状病毒病(COVID-19)大流行导致患者因担心感染病毒而不愿就医,尤其是在纽约市,该市是疫情高峰期的震中。本研究的主要目的是评估接受肺癌肺切除术患者的安全性以及医护人员的安全性,使用 COVID-19 检测、症状和早期患者结局。

方法

回顾性分析了 2020 年 3 月 13 日至 5 月 4 日期间确诊或疑似患有肺部恶性肿瘤且接受切除术的患者。

结果

在 2020 年 3 月 13 日至 5 月 4 日期间,有 2087 例 COVID-19 患者入院,曼哈顿校区(医院容量的 80%)的每日中位数为 299 例。在此期间,在 45 名符合手术条件的外科候选患者中,有 21 名(中位年龄 72 岁)接受了肺切除术-13 例肺叶切除术,6 例节段切除术和 2 例全肺切除术,由照顾 COVID-19 患者的同一医护人员进行。没有患者发生重大并发症,5 例患者出现轻微并发症,中位住院时间为 2 天。没有先前 COVID-19 检测阴性的患者(n=20/21)或医护人员(n=9:3 名外科医生、3 名外科助手、3 名麻醉师)出现 COVID-19 症状或检测结果阳性。

结论

在选定的患者中,即使在对在 COVID-19 患者人数众多的医院照顾 COVID-19 患者的医护人员进行手术,肺切除术治疗肺癌也是安全的。我们的患者或医护人员均未出现 COVID-19 症状,也没有患者出现重大发病率或死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3b1/7665486/3ec19339e290/ezaa332f2.jpg

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