Anwar Sumadi Lukman, Cahyono Roby, Hardiyanto Herjuna, Suwardjo Suwardjo, Darwito Darwito, Harahap Wirsma Arif
Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
Department of Surgery, Rumah Sakit Akademik (RSA), Universitas Gadjah Mada, Yogyakarta, 55291, Indonesia.
Ann Med Surg (Lond). 2021 Dec;72:103089. doi: 10.1016/j.amsu.2021.103089. Epub 2021 Nov 18.
Postoperative infection of Coronavirus Disease 2019 (COVID-19) has been associated with higher risks of mortality and pulmonary complication. Preoperative vaccination could significantly prevent postoperative-related mortality and morbidity particularly for cancer patients.
Cancer patients who were scheduled for elective major surgery were questioned for status and their willingness to receive COVID-19 vaccination and were prospectively monitored for the presence of postoperative COVID-19 infection and major complications.
During the period of April-July 2021, 367 patients with median age of 49 years were scheduled for cancer surgery. Procedures for breast cancer were the most frequently performed (N = 166, 45.2%). Surgery procedures with potential aerosol generating procedures (AGPs) were performed in total of 104 patients (28.3%). Only 6 of 367 patients (1.6%) were fully vaccinated in the day of surgery and 351 patients (95.6%) were willing to receive COVID-19 vaccination. Fully vaccinated patients were significantly higher among those who were living in urban areas (OR = 22.897, 95%CI:4.022-130.357, = 0.0001). Willingness to get the COVID-19 vaccination was significantly higher among female patients (OR = 4.661, 95%CI:1.685-12.896, P = 0.003). Postoperative COVID-19 infection was confirmed in 17 patients (4.6%) and major surgical complications were observed in 12 patients (3.3%). None of preoperatively vaccinated patients experienced postoperative COVID-19 infection or the related major complications.
Although prioritizing COVID-19 vaccination in preoperative cancer patients has been recommended to prevent postoperative fatalities, only a small proportion of our patients have been vaccinated. Preoperatively vaccinated patients show advantages in the prevention of postoperative COVID-19 infection and major surgery complications. The slow rollout and disparity in the vaccination progress for patients requiring a major cancer surgery need to be specifically addressed.
2019年冠状病毒病（COVID-19）术后感染与更高的死亡率和肺部并发症风险相关。术前接种疫苗可显著预防术后相关的死亡率和发病率，尤其是对癌症患者而言。
对计划进行择期大手术的癌症患者询问其疫苗接种状况及接种意愿，并对术后COVID-19感染和主要并发症的发生情况进行前瞻性监测。
在2021年4月至7月期间，367例年龄中位数为49岁的患者计划接受癌症手术。乳腺癌手术最为常见（N = 166，45.2%）。共有104例患者（28.3%）接受了可能产生气溶胶的手术操作（AGP）。在手术当天，367例患者中只有6例（1.6%）完成了全程接种，351例患者（95.6%）愿意接种COVID-19疫苗。居住在城市地区的患者中完成全程接种的比例显著更高（OR = 22.897，95%CI：4.022 - 130.357，P = 0.0001）。女性患者接种COVID-19疫苗的意愿显著更高（OR = 4.661，95%CI：1.685 - 12.896，P = 0.003）。17例患者（4.6%）确诊术后感染COVID-19，12例患者（3.3%）出现主要手术并发症。术前接种疫苗的患者均未发生术后COVID-19感染或相关主要并发症。
尽管建议对术前癌症患者优先接种COVID-19疫苗以预防术后死亡，但我们的患者中只有一小部分接种了疫苗。术前接种疫苗的患者在预防术后COVID-19感染和重大手术并发症方面显示出优势。对于需要进行重大癌症手术的患者，疫苗接种进展缓慢且存在差异的问题需要得到具体解决。
