Optimising Cancer Surgery During COVID-19: Experience of Tertiary Cancer Centre in Eastern India

Purpose The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods W...

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Published in:Indian journal of gynecologic oncology 2021, Vol.19 (2), p.29-29, Article 29
Main Authors: Das, Rekha, Nahak, Snigdha Rani, Parija, Jita, Das, Prafulla K., Sarangi, Lalatendu, Devi, Padmalaya, Pathy, Pramod C.
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Language:English
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Medicine
Medicine & Public Health
Oncology
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Surgical Oncology
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container_title Indian journal of gynecologic oncology
container_volume 19
creator Das, Rekha
Nahak, Snigdha Rani
Parija, Jita
Das, Prafulla K.
Sarangi, Lalatendu
Devi, Padmalaya
Pathy, Pramod C.
description Purpose The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done—complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I–IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0–3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1–6) days, and length of hospital stay was 7 (7–15) days. Clavien–Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% ( p  = 0.76). 10% in ASA I compared to 26% of ASA II ( p  = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 ( p  = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. Conclusions Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.
doi_str_mv 10.1007/s40944-021-00502-2
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Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done—complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I–IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0–3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1–6) days, and length of hospital stay was 7 (7–15) days. Clavien–Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% ( p  = 0.76). 10% in ASA I compared to 26% of ASA II ( p  = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 ( p  = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. 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Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done—complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I–IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0–3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1–6) days, and length of hospital stay was 7 (7–15) days. Clavien–Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% ( p  = 0.76). 10% in ASA I compared to 26% of ASA II ( p  = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 ( p  = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. 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Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done—complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I–IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0–3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1–6) days, and length of hospital stay was 7 (7–15) days. Clavien–Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% ( p  = 0.76). 10% in ASA I compared to 26% of ASA II ( p  = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 ( p  = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. Conclusions Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>33786366</pmid><doi>10.1007/s40944-021-00502-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-0969-4470</orcidid><oa>free_for_read</oa></addata></record>
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subjects Medicine
Medicine & Public Health
Oncology
Original
Original Article
Surgical Oncology
title Optimising Cancer Surgery During COVID-19: Experience of Tertiary Cancer Centre in Eastern India
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