Flattening the curve in oncologic surgery: Impact of Covid-19 on surgery at tertiary care cancer center
Flattening the curve in oncologic surgery: Impact of Covid-19 on surgery at tertiary care cancer center
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DOI：
10.1002/jso.26056
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发表时间：
2020-06-02
影响因子：
2.5
通讯作者：
Liu, Jesse Jun
中科院分区：
文献类型：
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作者：
Chang, Edward I.;Liu, Jesse Jun
引言新冠肺炎为医疗保健系统带来了巨大的变化，以“拉平曲线”;特别是外科手术，这些手术可能消耗重要的有限资源，更不用说对工作人员、麻醉师和外科医生的风险了。方法前瞻性比较2019年12月至2020年5月大流行期间和2018年12月至2019年5月相关时间段的外科手术病例。结果在美国宣布全国紧急状态之前，病例数量没有显著下降，允许癌症患者继续接受根治性肿瘤切除术，直到那时（428.3 +/- 51.5 vs 166.6 +/- 59.8例/周; P <0.001）。这一下降与假期期间的平均病例数量一致（213.8 +/- 76.8 vs 166.6 +/- 59.8例/周; P = 0.648）。对外科亚专科的评估表明，所有亚专科的恶性肿瘤发生率均显著下降，其中肉瘤下降最多（P = 0.002）和内分泌（P = .001）手术，而血管（P = .004）和胸部结论新型冠状病毒大大减少了肿瘤手术，但如果对患者进行适当的评估并分配资源，手术可以安全地进行，而不会损害使曲线变平和控制冠状病毒大流行的目标。
Introduction Covid-19 has ushered in drastic changes to the healthcare system in order to "flatten the curve"; in particular, surgical operations that can consume vital, limited resources, not to mention the risk to staff, anesthesiologists, and surgeons. However, under unique circumstances with diligent preparation, vital oncologic operations can be performed safely.Methods Prospective comparison of surgical cases during the pandemic from December 2019 to May 2020 to the correlating time frame from December 2018 to May 2019.Results A significant decline in case volume was not appreciated until the United States declared a national state of emergency, allowing patients with cancer to continue to undergo curative tumor resection until then (428.3 +/- 51.5 vs 166.6 +/- 59.8 cases/week; P < .001). The decrease was consistent with the mean case volume during the holidays (213.8 +/- 76.8 vs 166.6 +/- 59.8 case/week; P = .648). Evaluation of surgical subspecialties demonstrated a significant decrease for all subspecialties with the greatest decline in sarcoma (P = .002) and endocrine (P = .001) surgeries, while vascular (P = .004) and thoracic (P = .011) surgeries had the least.Conclusions The novel coronavirus has drastically reduced oncologic operations, but with proper evaluation of patients and allocation of resources, surgery can be performed safely without compromising the aim to flatten the curve and control the coronavirus pandemic.