优化新冠疫情期间的癌症手术：印度东部三级癌症中心的经验
Optimising Cancer Surgery During COVID-19: Experience of Tertiary Cancer Centre in Eastern India.
作者信息
Das Rekha, Nahak Snigdha Rani, Parija Jita, Das Prafulla K, Sarangi Lalatendu, Devi Padmalaya, Pathy Pramod C
机构信息
Department of Anaesthesiology, AHPGIC, Cuttack, Odisha India.
Department of Pathology, AHPGIC, Cuttack, Odisha India.
出版信息
Indian J Gynecol Oncol. 2021;19(2):29. doi: 10.1007/s40944-021-00502-2. Epub 2021 Mar 26.
PURPOSE
The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic.
METHODS
We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020.
RESULTS
A total of 457 surgeries were done-complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I-IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0-3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1-6) days, and length of hospital stay was 7 (7-15) days. Clavien-Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% ( = 0.76). 10% in ASA I compared to 26% of ASA II ( = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 ( = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period.
CONCLUSIONS
Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.
目的
新冠疫情及全国封锁导致癌症手术的管理面临挑战。继续开展癌症手术是所有人面临的一项挑战。我们介绍了在疫情初期一家患者数量众多但资源有限的癌症中心开展癌症手术的经验。
方法
我们回顾性分析了2020年4月1日至6月30日期间手术室关于手术和麻醉的数据库。
结果
共进行了457例手术——复杂大手术、大手术、中等手术和小手术分别占43%、25%、12%和20%。患者的中位年龄为50岁，76%的患者年龄在60岁以下。中位美国麻醉医师协会（ASA）分级为I级（I - IV级），97%为ASA I级和II级。东部肿瘤协作组（ECOG）中位评分为0分（0 - 3分），92%的患者评分为0分和1分。在区域麻醉下进行的大手术占30.7%。重症监护病房（ICU）中位住院时间为1天（1 - 6天），住院时间为7天（7 - 15天）。60岁以上患者的Clavien - Dindo II级并发症发生率为16.4%，60岁以下患者为17.6%（P = 0.76）。ASA I级患者的II级并发症发生率为10%，而ASA II级患者为26%（P = 0.00）；ECOG评分为0分和1分的患者II级并发症发生率为15.9%，而ECOG评分为3分和4分的患者为30.9%（P = 0.01）。4例（1%）患者发生了≥III级CD并发症。52%的患者在术前进行了新冠检测，术后无阳性病例。
结论
通过采用和实施符合我们中心有限资源的机构政策，我们促进了癌症手术的开展。
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