Department of Oesophago-Gastric Surgery, Salford Royal NHS Foundation Trust, Salford Royal Hospital, Manchester, UK.
Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Ann Surg Oncol. 2021 Sep;28(9):4816-4826. doi: 10.1245/s10434-021-09885-0. Epub 2021 Apr 17.
The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery.
This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group.
In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19.
Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.
COVID-19 大流行导致患者护理发生了前所未有的变化，包括癌症手术的暂停。随着主要复杂的微创和开放手术的重新引入，人们对 COVID-19 相关风险对患者和医护人员的担忧已经提出。本研究检查了重新引入主要食管胃（EG）手术后 COVID-19 对患者和医护人员的相关风险。
这是一项国际多中心观察性研究，连续纳入了 9 家欧洲中心接受开放和微创食管切除术和胃切除术治疗恶性或良性疾病的患者。这些中心所在的地区人口 COVID-19 发病率较高，患者招募时间为 2020 年 5 月 1 日至 7 月 1 日。主要终点是 30 天 COVID-19 相关死亡率。所有参与患者手术护理的工作人员均被邀请完成一项与健康相关的调查，以评估该组 COVID-19 的发生率。
共有 158 例患者纳入研究（71 例食管切除术，82 例胃切除术）。总体而言，有 87 例患者（57%）接受了微创外科手术（59 例食管切除术，28 例胃切除术）。共有 403 名工作人员符合纳入条件，其中 313 名（78%）完成了健康调查。各中心采取了不同的措施来降低患者和工作人员 COVID-19 的风险。术后没有患者发生 COVID-19。有 2 名医护人员发生了自限性 COVID-19。
为了最大程度地降低 COVID-19 感染风险而采取的预防措施，使微创和开放 EG 手术能够安全地重新用于患者和医护人员。需要进一步研究以确定针对 COVID-19 的缓解措施的最低要求。
