Trinity St. James's Cancer Institute, Dublin, Ireland.
Mercy University Hospital, Cork, Ireland.
Ir J Med Sci. 2022 Apr;191(2):831-837. doi: 10.1007/s11845-021-02597-0. Epub 2021 Mar 16.
The emergence of the novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the coronavirus disease COVID-19 has impacted enormously on non-COVID-19-related hospital care. Curtailment of intensive care unit (ICU) access threatens complex surgery, particularly impacting on outcomes for time-sensitive cancer surgery. Oesophageal cancer surgery is a good example. This study explored the impact of the pandemic on process and short-term surgical outcomes, comparing the first wave of the pandemic from April to June in 2020 with the same period in 2019.
Data from all four Irish oesophageal cancer centres were reviewed. All patients undergoing resection for oesophageal malignancy from 1 April to 30 June inclusive in 2020 and 2019 were included. Patient, disease, and peri-operative outcomes (including COVID-19 infection) were compared.
In 2020, 45 patients underwent oesophagectomy, and 53 in the equivalent period in 2019. There were no differences in patient demographics, co-morbidities, or use of neoadjuvant therapy. The median time to surgery from neoadjuvant therapy was 8 weeks in both 2020 and 2019. There were no significant differences in operative interventions between the two time periods. There was no difference in operative morbidity in 2020 and 2019 (28% vs 40%, p = 0.28). There was no in-hospital mortality in either period. No patient contracted COVID-19 in the perioperative period.
Continuing surgical resection for oesophageal cancer was feasible and safe during the COVID-19 pandemic in Ireland. The national response to this threat was therefore successful by these criteria in the curative management of oesophageal cancer.
新型冠状病毒（SARS-CoV-2）和冠状病毒病（COVID-19）的出现对非 COVID-19 相关的医院护理产生了巨大影响。重症监护病房（ICU）通道的减少威胁着复杂的手术，特别是对时间敏感的癌症手术的结果产生影响。食道癌手术就是一个很好的例子。本研究通过比较 2020 年 4 月至 6 月的第一波疫情与 2019 年同期的情况，探讨了疫情对手术过程和短期手术结果的影响。
对爱尔兰的四个食道癌中心的数据进行了回顾。所有 2020 年 4 月 1 日至 6 月 30 日期间以及 2019 年同期接受食道癌切除术的患者均纳入研究。比较了患者、疾病和围手术期结果（包括 COVID-19 感染）。
2020 年，45 例患者接受了食道癌切除术，而 2019 年同期则有 53 例。患者的人口统计学特征、合并症或新辅助治疗的使用情况均无差异。新辅助治疗后手术时间中位数在 2020 年和 2019 年均为 8 周。两个时期的手术干预措施无显著差异。2020 年和 2019 年手术发病率分别为 28%和 40%，差异无统计学意义（p=0.28）。两个时期均无院内死亡病例。在围手术期期间，没有患者感染 COVID-19。
在爱尔兰 COVID-19 大流行期间，继续进行食道癌切除术是可行和安全的。从这些标准来看，国家对这一威胁的反应在食道癌的治愈性治疗方面是成功的。
