Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

• Published in: Annals of surgical oncology 2021-09, Vol.28 (9), p.4816-4826
• Main Authors: Alasmar, Mohamed, Kausar, Afsana, Borgstein, Alexander Berend-Jan, Moons, Johnny, Doran, Sophie, de Pascale, Stefano, Restrepo, Rafael, Verrengia, Apollonia, Alloggio, Mariella, Delgado, Ana Moro, Kumar, Sacheen, del Val, Ismael Díez, Giocapuzzi, Simone, Baiocchi, Gian Luca, de Vega Irañeta, Marta, Salcedo, Gabriel, Vorwald, Peter, Fumagalli Romario, Uberto, Nafteux, Philippe, Gisbertz, Suzanne, Chaudry, Mohammed Asif, Alkhaffaf, Bilal
• Format: Article
• Language: English
• Subjects: Cohort analysis; Coronaviruses; COVID-19; Gastrectomy; Gastrointestinal Oncology; Gastrointestinal surgery; Medical personnel; Medicine; Medicine & Public Health; Minimally invasive surgery; Oncology; Pandemics; Patients; Surgery; Surgical Oncology; Workers
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-021-09885-0

Introduction The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery. Patients and Methods This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group. Results In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19. Conclusions Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.