在 COVID-19 大流行期间进行癌症手术：一家综合性癌症中心通过 RT-PCR 和胸部 CT 扫描进行术前筛查的经验。

Cancer surgery during the COVID-19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT-PCR and chest CT scan.

机构信息

Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France.

Department of Laboratory Medicine and Pathology, Paris-Saclay University, Gustave Roussy, Villejuif, France.

出版信息

J Surg Oncol. 2021 Mar;123(4):815-822. doi: 10.1002/jso.26335. Epub 2021 Feb 1.

DOI:10.1002/jso.26335

PMID:33524172

Abstract

BACKGROUND AND OBJECTIVES

During the worldwide pandemic of coronavirus disease 2019 (COVID-19), oncological procedures considered to be urgent could not be delayed, and a specific procedure was required to continue surgical activity. The objective was to assess the efficacy of our preoperative screening algorithm.

METHODS

This observational retrospective study was performed between the 25th of March and the 12th of May 2020 in a comprehensive cancer center in France. Patients undergoing elective oncologic surgery were tested by preoperative nasopharyngeal reverse-transcription polymerase chain reaction (RT-PCR) that could be associated with a chest computerized tomography (CT) scan.

RESULTS

Of the 510 screening tests (in 477 patients), only 5% (15/477) were positive for COVID-19 in 24 patients (18 RT-PCR+ and 7 CT scan+/RT-PCR-). Four patients were ultimately false positives based on the CT scan. In total, only 4.2% (20/477) of the patients were COVID-19+. The positivity rate decreased with time after the containment measures were implemented (from 7.4% to 0.8%). In the COVID-19+ group, 20% of the patients had postoperative pulmonary complications, whereas this was the case for 5% of the patients in the COVID-19 group.

CONCLUSIONS

Maintaining secure surgical activity is achievable and paramount in oncology care, even during the COVID-19 pandemic, with appropriate screening based on preoperative RT-PCR.

摘要

背景与目的

在 2019 年冠状病毒病（COVID-19）全球大流行期间，不能延迟被认为是紧急的肿瘤学程序，需要特定的程序来继续外科手术活动。目的是评估我们的术前筛查算法的疗效。

方法

本观察性回顾性研究于 2020 年 3 月 25 日至 5 月 12 日在法国的一家综合癌症中心进行。接受择期肿瘤外科手术的患者通过术前鼻咽逆转录聚合酶链反应（RT-PCR）进行检测，可同时进行胸部计算机断层扫描（CT）检查。

结果

在 510 次筛查检测（477 例患者）中，仅 24 例患者（18 例 RT-PCR+和 7 例 CT 扫描+/RT-PCR-）的 24 例患者（24 例患者）有 5%（15/477）为 COVID-19 阳性。最终有 4 例基于 CT 扫描为假阳性。总共有 4.2%（20/477）的患者为 COVID-19+。在实施遏制措施后，阳性率随时间降低（从 7.4%降至 0.8%）。在 COVID-19+组中，20%的患者发生术后肺部并发症，而 COVID-19 组中这一比例为 5%。