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对患者进行的主要泌尿外科癌症手术是安全的,在2019年冠状病毒病大流行期间应鼓励进行外科培训:一项关于30天结果的多中心分析

Major Urological Cancer Surgery for Patients is Safe and Surgical Training Should Be Encouraged During the COVID-19 Pandemic: A Multicentre Analysis of 30-day Outcomes.

作者信息

Tan Wei Shen, Arianayagam Rajan, Khetrapal Pramit, Rowe Edward, Kearley Samantha, Mahrous Ahmed, Pal Raj, Fowler William, Heer Rakesh, Elajnaf Mohamed, Douglas-Moore Jayne, Leyshon Griffiths T R, Voss James, Wilby Daniel, Al Kadhi Omar, Noel Jonathan, Vasdev Nikhil, McKay Alastair, Ahmad Imran, Abu-Nayla Islam, Lamb Benjamin, Hill George T, Narahari Krishna, Kynaston Howard, Yousuf Arzu, Kusuma Venkata R M, Cresswell Jo, Cooke Pete, Chakravarti Aniruddha, Barod Ravi, Bex Axel, Kelly John D

机构信息

Division of Surgery and Interventional Science, University College London, London, UK.

Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.

出版信息

Eur Urol Open Sci. 2021 Mar;25:39-43. doi: 10.1016/j.euros.2021.01.005. Epub 2021 Jan 9.

Abstract

UNLABELLED

COVID-19 has resulted in the deferral of major surgery for genitourinary (GU) cancers with the exception of cancers with a high risk of progression. We report outcomes for major GU cancer operations, namely radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy performed at 13 major GU cancer centres across the UK between March 1 and May 5, 2020. A total of 598 such operations were performed. Four patients (0.7%) developed COVID-19 postoperatively. There was no COVID-19-related mortality at 30 d. A minimally invasive approach was used in 499 cases (83.4%). A total of 228 cases (38.1%) were described as training procedures. Training case status was not associated with a higher American Society of Anesthesiologists (ASA) score ( =  0.194) or hospital length of stay (LOS;  >  0.05 for all operation types). The risk of contracting COVID-19 was not associated with longer hospital LOS ( =  0.146), training case status ( =  0.588), higher ASA score ( =  0.295), or type of hospital site ( =  0.303). Our results suggest that major surgery for urological cancers remains safe and training should be encouraged during the ongoing COVID-19 pandemic provided appropriate countermeasures are taken. These real-life data are important for policy-makers and clinicians when counselling patients during the current pandemic.

PATIENT SUMMARY

We collected outcome data for major operations for prostate, bladder, and kidney cancers during the COVID-19 pandemic. These surgeries remain safe and training should be encouraged during the ongoing pandemic provided appropriate countermeasures are taken. Our real-life results are important for policy-makers and clinicians when counselling patients during the COVID-19 pandemic.

摘要

未标注

新型冠状病毒肺炎(COVID-19)导致除具有高进展风险的癌症外,泌尿生殖系统(GU)癌症的大手术延期。我们报告了2020年3月1日至5月5日期间在英国13个主要GU癌症中心进行的主要GU癌症手术的结果,即根治性前列腺切除术(RP)、根治性膀胱切除术(RC)、根治性肾切除术(RN)、部分肾切除术(PN)和肾输尿管切除术。共进行了598例此类手术。4例患者(0.7%)术后发生COVID-19。30天时无COVID-19相关死亡病例。499例(83.4%)采用了微创方法。共有228例(38.1%)被描述为培训手术。培训病例状态与较高的美国麻醉医师协会(ASA)评分(=0.194)或住院时间(LOS;所有手术类型均>0.05)无关。感染COVID-19的风险与较长的住院LOS(=0.146)、培训病例状态(=0.588)、较高的ASA评分(=0.295)或医院地点类型(=0.303)无关。我们的结果表明,泌尿外科癌症的大手术仍然安全,并且在持续的COVID-19大流行期间,只要采取适当的对策,就应鼓励进行培训。这些真实数据对于政策制定者和临床医生在当前大流行期间为患者提供咨询时非常重要。

患者总结

我们收集了COVID-19大流行期间前列腺癌、膀胱癌和肾癌大手术的结果数据。这些手术仍然安全,并且在持续的大流行期间,只要采取适当的对策,就应鼓励进行培训。我们的真实结果对于政策制定者和临床医生在COVID-19大流行期间为患者提供咨询时非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/290a/8317801/b361505f448c/gr1.jpg

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