Is Elective Cancer Surgery Safe During the COVID-19 Pandemic?
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ORIGINAL SCIENTIFIC REPORT
Is Elective Cancer Surgery Safe During the COVID-19 Pandemic? Chenchen Ji1 • Kaushiki Singh1 • Alison Zoe Luther1,2
•
Avi Agrawal1
Accepted: 8 July 2020 / Published online: 6 August 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background The COVID-19 pandemic has resulted in a significant decrease in the number of elective cancer operations performed. Cancer patients are felt to be a high-risk group for COVID-19, and therefore, concerns have been raised regarding the safety of operating during this time; however, the potential risk of cancer progression if untreated must also be considered. The aim of this study was therefore to identify the incidence of COVID-19 postoperatively in patients undergoing elective cancer surgery of all types. Methods Data were collected on all patients who had an elective therapeutic cancer operation in a single large district general hospital, where standard COVID-19 precautions were in place, between 01/02/2020 and 27/4/2020, Follow-up was for a minimum of 2 weeks post-discharge. The primary outcome was the incidence of COVID-19 during the follow-up period. Results A total of 621 elective cancer surgeries, from a range of specialities, were performed during the study period, with 55% (n = 341) being done as day cases. None of the patients were positive for COVID-19 post-operatively using reverse transcriptase polymerase chain reaction testing. Conclusions The risk of COVID-19 following elective cancer surgery in this group of high-risk patients appears to be minimal in this study. With further precautions being introduced to reduce the risk of transmission of COVID-19, an increase in the rate of elective cancer surgery should be a current priority for all hospitals where possible.
Introduction The COVID-19 pandemic was declared a global health emergency by the World Health Organisation (WHO) on 31 January 2020 [1], and currently 3 986 119 cases of COVID-19 have been reported worldwide [2]. The overall mortality risk from COVID-19 has been challenging to assess, but the most recent estimation from WHO was & Alison Zoe Luther [email protected] 1
Department of Surgery, Queen Alexandra Hospital, Portsmouth, UK
2
Department of Breast Surgery, Queen Alexandra Hospital, Cosham PO6 3LY, UK
3.4% [3–6]. Death rates however have been shown to be much higher in the elderly population, as well as in individuals with comorbidities, or those undergoing treatments resulting in immunosuppression [5, 7–9]. Transmission of COVID-19 is primarily via large droplet spread, and therefore, many countries have instituted major public health strategies including nationwide ‘‘lockdowns’’ and social distancing as an attempt to reduce infection rates [6, 10, 11]. All health services have made significant changes to face the challenges of COVID-19, aiming to both equip institutions to manage a surge of critically ill patients, and also to minimise face to face contact where possible to reduce further transmission. This has resulted in a substantial redu
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