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Al-Masri M, Safi Y, Alayyan O, Kardan R, Al Khraisat L, Massad A, Alsadi F. Optimizing timing for elective surgery in cancer patients following COVID-19 infection; a post-pandemic analysis. Infect Agent Cancer 2025; 20:25. [PMID: 40234975 PMCID: PMC11998221 DOI: 10.1186/s13027-025-00646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/14/2025] [Indexed: 04/17/2025] Open
Abstract
INTRODUCTION The COVID-19 pandemic introduced challenges including delaying elective surgery. For cancer patients, reducing delays is preferred to prevent unfavorable outcomes. there is a lack of consensus regarding the optimal timing of elective surgery following a SARS-CoV-2. This study aimed to find the optimal time to elective surgery to minimize 30-day postoperative morbidity and mortality. METHODS This is a retrospective chart review of all adult patients who underwent elective surgery with a confirmed preoperative COVID-19 diagnosis between September 2020 and April 2023. Patients' elective surgeries delays were examined to determine the optimal time to surgery in terms of postoperative complications. Analysis was controlled for age, ASA score, comorbidities, and smoking status. RESULTS 358 records examined, 94.7% had delayed surgery and 5.3% had cancelled surgery. The optimal time to surgery was ≥ 17 days to minimize postoperative pulmonary complications [OR: 0.299, p = 0.048], other postoperative complications [OR: 0.459, p = 0.01], and a decrease in length of hospital stay. In multivariate analysis, the only significant predictors for postoperative complications were time to surgery; surgery ≥ 17 days after diagnosis had better postoperative outcomes [p < 0.001], and COVID-19 symptoms status [p = 0.019]. CONCLUSION The best time to surgery in this cohort is at least 17 days (or a range of 2-3 weeks) for optimal results. Further research is needed to investigate the effect of such delays on oncological outcomes in this cohort.
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Affiliation(s)
- Mahmoud Al-Masri
- King Hussein Cancer Center, Amman, Jordan.
- University of Jordan, Amman, Jordan.
- Department of Surgery, King Hussein Cancer Center, Queen Rania Al Abdullah Street, P.O. Box 1269, Al-Jubeiha, Amman, 11941, Jordan.
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Trébol J, Carabias-Orgaz A, Esteban-Velasco MC, García-Plaza A, González-Muñoz JI, Sánchez-Casado AB, Parreño-Manchado FC, Eguía-Larrea M, Alcázar-Montero JA. Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes. World J Methodol 2024; 14:92612. [PMID: 38983654 PMCID: PMC11229877 DOI: 10.5662/wjm.v14.i2.92612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The first wave of coronavirus disease 2019 (COVID-19) pandemic in Spain lasted from middle March to the end of June 2020. Spanish population was subjected to lockdown periods and scheduled surgeries were discontinued or reduced during variable periods. In our centre, we managed patients previously and newly diagnosed with cancer. We established a strategy based on limiting perioperative social contacts, preoperative screening (symptoms and reverse transcription-polymerase chain reaction) and creating separated in-hospital COVID-19-free pathways for non-infected patients. We also adopted some practice modifications (surgery in different facilities, changes in staff and guidelines, using continuously changing personal protective equipment…), that supposed new inconveniences. AIM To analyse cancer patients with a decision for surgery managed during the first wave, focalizing on outcomes and pandemic-related modifications. METHODS We prospectively included adults with a confirmed diagnosis of colorectal, oesophago-gastric, liver-pancreatic or breast cancer with a decision for surgery, regardless of whether they ultimately underwent surgery. We analysed short-term outcomes [30-d postoperative morbimortality and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection] and outcomes after 3 years (adjuvant therapies, oncological events, death, SARS-CoV-2 infection and vaccination). We also investigated modifications to usual practice. RESULTS From 96 included patients, seven didn't receive treatment that period and four never (3 due to COVID-19). Operated patients: 28 colon and 21 rectal cancers; laparoscopy 53.6%/90.0%, mortality 3.57%/0%, major complications 7.04%/25.00%, anastomotic leaks 0%/5.00%, 3-years disease-free survival (DFS) 82.14%/52.4% and overall survival (OS) 78.57%/76.2%. Six liver metastases and six pancreatic cancers: no mortality, one major complication, three grade A/B liver failures, one bile leak; 3-year DFS 0%/33.3% and OS 50.0%/33.3% (liver metastases/pancreatic carcinoma). 5 gastric and 2 oesophageal tumours: mortality 0%/50%, major complications 0%/100%, anastomotic leaks 0%/100%, 3-year DFS and OS 66.67% (gastric carcinoma) and 0% (oesophagus). Twenty breast cancer without deaths/major complications; 3-year OS 100% and DFS 85%. Nobody contracted SARS-CoV-2 postoperatively. COVID-19 pandemic-related changes: 78.2% treated in alternative buildings, 43.8% waited more than 4 weeks, two additional colostomies and fewer laparoscopies. CONCLUSION Some patients lost curative-intent surgery due to COVID-19 pandemic. Despite practice modifications and 43.8% delays higher than 4 weeks, surgery was resumed with minimal changes without impacting outcomes. Clean pathways are essential to continue surgery safely.
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Affiliation(s)
- Jacobo Trébol
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Ana Carabias-Orgaz
- Oftalmología, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
| | - María Carmen Esteban-Velasco
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Asunción García-Plaza
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Juan Ignacio González-Muñoz
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Ana Belén Sánchez-Casado
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Felipe Carlos Parreño-Manchado
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
| | - Marta Eguía-Larrea
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
| | - José Antonio Alcázar-Montero
- Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca 37007, Salamanca, Spain
- Cirugía, Universidad de Salamanca, Salamanca 37007, Salamanca, Spain
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Singh S, Surendran S, Yacob M, Paul N, Samarasam I. Impact of Covid-19 pandemic on upper gastrointestinal cancer services: Experience from an oncosurgical unit. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:206-209. [PMID: 36715044 DOI: 10.25259/nmji_751_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background The Covid-19 pandemic continues to affect the delivery of cancer care across the world. We evaluated the impact of the pandemic on the delivery of cancer care, to patients diagnosed with upper gastrointestinal (UGI) tract malignancies, during the first 4 months of the pandemic in India. Methods We retrospectively analysed a database of patients with UGI malignancies discussed in the Multidisciplinary Tumour Board (MDTB) between 24 March and 24 July 2020. The results in the study group were compared to that of a similar group of patients from the corresponding period in 2019. Results A total of 117 and 61 patients were discussed in the MDTB in 2019 and 2020, respectively, thereby showing a 48% reduction in the number of new cases seen in 2020. The reduction in the number of new cases was huge for oesophageal cancer (53-13; 75.5% reduction), compared to gastric cancer (53-43; 18.9%). The proportion of patients with metastatic disease at presentation was significantly higher in 2020, compared to 2019 (39.3% v. 23.1%; p=0.023). In 8 (13.1%) patients, the pre-existing treatment protocol had to be modified to suit the prevailing pandemic situation. Two patients with gastric cancer acquired asymptomatic Covid-19 infection during the treatment, which delayed the delivery of further therapy. Oncosurgeries were less in 2020 compared to 2019 (25 v. 63). The rate of 30-day major postoperative complications in 2020 was comparable with that in 2019 (12% v. 6.3%; p=0.4). Conclusions The number of new patients with UGI cancer, seeking elective cancer care and the number of oncosurgical procedures reduced during the Covid-19 pandemic. Continuous delivery of UGI cancer services was ensured during the pandemic through clinical prioritization, the adaptation of specific care pathways and selective modification of protocols, to suit the prevailing local conditions.
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Affiliation(s)
- Sumit Singh
- Division of Surgery, Upper GI Surgery Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Suraj Surendran
- Division of Surgery, Upper GI Surgery Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Myla Yacob
- Division of Surgery, Upper GI Surgery Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Negine Paul
- Division of Surgery, Upper GI Surgery Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Inian Samarasam
- Division of Surgery, Upper GI Surgery Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Lopes A, Pastore CBP, Deckers P, Halla IKMW, Dias ALR, da Mata MVM, do Nascimento Martins A, Viu MM, Lopez RVM, Yamada AD. Oncological Surgery During the COVID-19 Pandemic: Effectiveness of Preoperative Screening and Factors Associated with Postoperative SARS-CoV-2 Infection. Ann Surg Oncol 2022; 29:2155-2162. [PMID: 35000079 PMCID: PMC8742686 DOI: 10.1245/s10434-021-11195-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/14/2021] [Indexed: 12/11/2022]
Abstract
Background Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission. Methods This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days. Results A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%. The length of stay (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.04–1.11; p < 0.001), surgical time (OR 1.004; 95% CI 1.001–1.008; p = 0.023), intensive care unit admission (OR 7.7; 95% CI 2.03–29.28; p = 0.003), and hospital readmissions (OR 9.56; 95% CI 2.50–36.56; p = 0.001) were associated with postoperative coronavirus disease (COVID-19). Using unadjusted and adjusted logistic regression, length of stay (OR 1.08; 95% CI 1.04–1.11; p < 0.001), and readmission (OR 9.02; 95% CI 2.30–35.48; p = 0.002) were independent factors of postoperative COVID-19. Conclusions Screening patients preoperatively may reduce in-hospital SARS-CoV-2 transmission. Length of stay and readmission were independently correlated with postoperative COVID-19.
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Affiliation(s)
- André Lopes
- Department of Gynecology, São Camilo Oncologia, São Paulo, Brazil.
- Nucleo de Pesquisa e Ensino da Rede São Camilo, São Paulo, Brazil.
| | | | - Paula Deckers
- Department of Gynecology, São Camilo Oncologia, São Paulo, Brazil
| | | | | | | | | | | | - Rossana Veronica Mendoza Lopez
- Oncology Translational Research Center, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Salehi O, Alarcon SV, Vega EA, Kutlu OC, Kozyreva O, Chan JA, Kazakova V, Harz D, Conrad C. COVID-19's Impact on Cancer Care: Increased Emotional Stress in Patients and High Risk of Provider Burnout. J Gastrointest Surg 2022; 26:1-12. [PMID: 34027579 PMCID: PMC8141360 DOI: 10.1007/s11605-021-05032-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/26/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND COVID-19's precise impact on cancer patients and their oncologic care providers remains poorly understood. This study aims at comparatively analyzing COVID-19's effect on cancer care from both patient and provider perspectives. METHODS A multi-institutional survey was developed to assess COVID-19-specific concerns regarding treatment, safety, and emotional stress through 5-point Likert-type prompts and open-ended questions before and during the pandemic. Wilcoxon signed-rank and rank-sum tests were used to analyze before/during answers for providers and patients independently. Open-ended responses were assessed using inductive thematic analysis. RESULTS The survey was completed by 104 (69.3%) patients and 50 (50%) providers. Patients demonstrated a significant change in only 1 of 15 Likert prompts. Most significant were increased concern regarding susceptibility to infection [z = 2.536, p = 0.011] and concerns regarding their cancer outcome [z = 4.572, p < 0.001]. Non-physician providers demonstrated significant change in 8 of 13 Likert prompts, whereas physicians had all 13 Likert prompts change in the COVID-19 setting. Physicians believed care to be more poorly planned [z = -3.857, p ≤ 0.001], availability of protective personal equipment to be more limited [z = -4.082, p < 0.001], and were significantly concerned infecting family members [z = 4.965, p < 0.001]. CONCLUSIONS While patients had more difficulty coping with their cancer, they did not perceive significant differences in their actual treatment. This suggests the need for a renewed focus on patients coping with cancer. Among providers, physicians more than any other provider group had a strong negative perception of COVID-19's impact on healthcare, suggesting the need for novel approaches to target physician burnout.
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Affiliation(s)
- Omid Salehi
- Department of Surgery, St. Elizabeth's Medical Center, Tufts University School of Medicine, 11 Nevins St., Suite 201, Brighton, MA, 02135, USA
| | - Sylvia V Alarcon
- Department of Medical Oncology & Hematology, St. Elizabeth's Medical Center and Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard School of Medicine, Boston, MA, USA
| | - Eduardo A Vega
- Department of Surgery, St. Elizabeth's Medical Center, Tufts University School of Medicine, 11 Nevins St., Suite 201, Brighton, MA, 02135, USA
| | - Onur C Kutlu
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Olga Kozyreva
- Department of Medical Oncology & Hematology, St. Elizabeth's Medical Center and Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard School of Medicine, Boston, MA, USA
| | - Jennifer A Chan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard School of Medicine, Boston, MA, USA
| | - Vera Kazakova
- Department of Internal Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Dominique Harz
- MMSc Medical Education Program, Harvard Medical School, Harvard University, Boston, MA, USA
- Escuela de Odontología, Pontificie Universidad Católica de Chile, Santiago, Chile
| | - Claudius Conrad
- Department of Surgery, St. Elizabeth's Medical Center, Tufts University School of Medicine, 11 Nevins St., Suite 201, Brighton, MA, 02135, USA.
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Bontzos G, Gkiala A, Karakosta C, Maliotis N, Detorakis ET. COVID-19 in Ophthalmology. Current Disease Status and Challenges during Clinical Practice. MAEDICA 2021; 16:668-680. [PMID: 35261670 PMCID: PMC8897783 DOI: 10.26574/maedica.2020.16.4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose: The novel coronavirus disease 2019 (COVID-19) has raised a global public health concern. The purpose of this review is to summarize the evidence currently available on COVID-19 for its ocular implications and manifestations from both pathogenetic and clinical standpoints. Methods: For this narrative review, more than 100 relevant scientific articles were considered from various databases (PubMed, Google Scholar, and Science Direct) using keywords such as coronavirus outbreak, COVID-19, ophthalmology, ocular symptoms. Results:Daily healthcare both from patient and physician perspective, as well as on some guidelines regarding prevention and management have dramatically changed over the last few months. Although COVID-19 infection mainly affects the respiratory system as well as the gastrointestinal, cardiovascular, and urinary systems, it may cause a wide spectrum of ocular manifestations. Various challenges have to be faced to minimize exposure for both patients and physicians. Conclusion:The risk of COVID-19 infection should be considered and medical care should be prioritized for urgent cases. Appropriate management for patients with chronic cases that may result in adverse outcomes should not be neglected, while patients that can be monitored remotely should be identified.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Anastasia Gkiala
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Christina Karakosta
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Neofytos Maliotis
- Department of Ophthalmology, General Hospital of Nikaia "Agios Panteleimon", 18454 Athens, Greece
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Hasan MZ, Neill R, Das P, Venugopal V, Arora D, Bishai D, Jain N, Gupta S. Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries. BMJ Glob Health 2021; 6:e005667. [PMID: 34135071 PMCID: PMC8210663 DOI: 10.1136/bmjgh-2021-005667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Integrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features. METHODS A systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review. RESULTS The literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government's stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration. CONCLUSION A wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.
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Affiliation(s)
- Md Zabir Hasan
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rachel Neill
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Priyanka Das
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Vasuki Venugopal
- Department of Health and Family Welfare, Government of Gujarat, Gandhinagar, India
| | - Dinesh Arora
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nishant Jain
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH India Office, New Delhi, India
| | - Shivam Gupta
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Sozutek A, Seker A, Kuvvetli A, Ozer N, Genc IC. Evaluating the feasibility of performing elective gastrointestinal cancer surgery during the COVID-19 pandemic: An observational study with 60 days follow-up results of a tertiary referral pandemic hospital. J Surg Oncol 2021; 123:834-841. [PMID: 33559133 PMCID: PMC8013399 DOI: 10.1002/jso.26396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/09/2021] [Accepted: 01/16/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has interfered with the treatment algorithm for patients with gastrointestinal (GIS) cancer, resulting in deferral of surgery. We presented the outcomes of our patients to evaluate whether surgery could be safely performed and followed-up without delaying any stage of GIS cancer during the pandemic. METHODS This was an observational study of 177 consecutive patients who underwent elective GIS cancer surgery between March 11 and November 1, 2020. They were assessed regarding their perioperative and 60 days follow-up results for either surgical or COVID-19 status. Morbidity was determined according to the Clavien-Dindo classification (CDC). Continuous and categorical data were presented as median ± SD and number with percentage (%), respectively. RESULTS The study included 44 gastric, 33 pancreatic, 40 colon, and 59 rectal cancer patients. All patients underwent surgery and received neo/adjuvant treatments without delay. The overall morbidity (CDC grade II-IV) and mortality rates were 10.1% and 3.9%, respectively. None of the patients or medical staff were infected with COVID-19 during the study period. CONCLUSION GIS cancer surgery can be safely performed even within a pandemic hospital if proper isolation measures can be achieved for both patients and health workers. Regardless of the tumor stage, surgery should not be deferred, depending on unstandardized algorithms.
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Affiliation(s)
- Alper Sozutek
- Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research HospitalHealth Sciences UniversityAdanaTurkey
| | - Ahmet Seker
- Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research HospitalHealth Sciences UniversityAdanaTurkey
| | - Adnan Kuvvetli
- Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research HospitalHealth Sciences UniversityAdanaTurkey
| | - Nazmi Ozer
- Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research HospitalHealth Sciences UniversityAdanaTurkey
| | - Ismail Caner Genc
- Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research HospitalHealth Sciences UniversityAdanaTurkey
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Manjandavida FP, Honavar SG, Kim U, Singh U, Menon V, Das S, Kaliki S, Palanivelu MS, Khetan V, Shah PK, Rishi P, Mulay K, Gandhi A, Vadhiraja BM, Reddy VA, Bhat S, Rao V. Ocular oncology practice guidelines during COVID-19 pandemic-An expert consensus. Indian J Ophthalmol 2020; 68:1281-1291. [PMID: 32587152 PMCID: PMC7574098 DOI: 10.4103/ijo.ijo_1669_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The outbreak of rapidly spreading COVID-19 pandemic in December 2019 has witnessed a major transformation in the health care system worldwide. This has led to the re-organization of the specialty services for the effective utilization of available resources and ensuring the safety of patients and healthcare workers. Suspension of oncology services will have major implications on cancer care due to delayed diagnosis and treatment leading to irreversible adverse consequences. Therefore various oncology organizations have called for a continuation of cancer care during this crisis with diligence. The COVID-19 pandemic has forced the clinicians to transform the components of care from screening to outpatient care and primary management. The purpose of this article is to establish guidelines and recommendations for ocular oncology in the management of ocular tumors set by a multidisciplinary team of experts including ocular, medical and radiation oncologists, and pathologists. As the pandemic is evolving fast, it will require constant updates and reformation of health strategies and guidelines for safe and quality health care.
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Affiliation(s)
- Fairooz P Manjandavida
- From Ocular Oncology and Oculoplasty Services, Horus Specialty Eye Care, Bangalore, India
| | - Santosh G Honavar
- Ocular Oncology and Oculoplasty Services, Center For Sight, Hyderabad, India
| | - Usha Kim
- Oculoplasty and Ocular Oncology Service, Aravind Eye Care, Madurai, India
| | - Usha Singh
- Advanced Eye Center, Medical Institute- PGIMER, Chandigarh, India
| | - Vikas Menon
- Ocular Oncology and Oculoplasty Services, Center For Sight, Delhi, India
| | - Sima Das
- Ocular Oncology and Oculoplasty Services, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
| | | | - Vikas Khetan
- Vitreoretina and Ocular Oncology Services, Sankara Nethralaya, Chennai, India
| | - Parag K Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| | - Pukhraj Rishi
- Vitreoretina and Ocular Oncology Services, Sankara Nethralaya, Chennai, India
| | - Kaustubh Mulay
- National Reporting Center for Ophthalmic Pathology, Center For Sight, Hyderabad, India
| | - Arpan Gandhi
- Ocular Pathology Services, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - B M Vadhiraja
- Department of Radiation Oncology, Manipal Hospitals, Bangalore, India
| | - Vijay Anand Reddy
- Medical and Radiation Oncology, Apollo Cancer Institute, Hyderabad, India
| | - Sunil Bhat
- Pediatric Hematology-Oncology and BMT, Narayana Health City, Bangalore, India
| | - Vasudha Rao
- Pediatric Oncology, Cytecare Cancer Hospitals, Bangalore, India
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