ABSTRACT
BACKGROUND Planned elective surgery had to be postponed for a large number of patients who tested positive for Covid-19 in the preoperative period. We aimed to assess the postoperative outcomes of patients who were operated on for elective indications, following recovery from Covid-19 infection. METHODS We did a retrospective study of patients who underwent elective general surgery between 1 April 2020 and 31 March 2021, following recovery from Covid-19. The 30-day postoperative morbidity and mortality were analysed. The data relevant for the study were retrieved from the hospital’s electronic medical records. RESULTS Of the 109 patients included, 54.1% were women and the median (range) age was 49 (16–76) years; 53.2% of operations were performed for benign indications and the rest were for malignancies. Eighty-five (78%) patients underwent surgery following recovery from an asymptomatic Covid-19 infection and 23 (21.1%) patients following recovery from mild Covid-19 infection; 73.3% of the operations were performed following a planned delay of 2– 5 weeks from the diagnosis of Covid-19. The 30-day major postoperative morbidity (Clavien–Dindo grade ?3) was 6.4%, the postoperative pulmonary morbidity was 0.9%, and there was no 30-day mortality. CONCLUSIONS Elective general surgical procedures can be done safely in patients who have recovered from asymptomatic and mild Covid-19 infection, following a minimum wait period of 2 weeks.
ABSTRACT
Background: Surgical referrals for lymph node biopsies are common, majority for diagnostic purposes. The indications and the diagnostic yield vary for different sites. We conducted an audit of the lymph node biopsies done over a period of seven months.Methods: The audit included 547 patients who underwent lymph node biopsies under local anesthesia in the department of general surgery over a seven-month period. Parameters such as overall diagnostic yield of lymph node biopsies, disease specific yield of lymph node biopsies with a primary focus on tuberculosis; site specific yield of lymph node biopsies and referral pattern for the request for lymph node biopsies were analysed.Results: 324 samples (59.2%) yielded a definite diagnosis, which included haematological malignancy 102 (31.5%), infectious diseases 131 (40.5%), and 59 (18.5%) malignancy. The diagnostic yield of supraclavicular lymph nodes was found to be highest (72.45%) and the axillary group the lowest (39.8%). The referral pattern seen was 314 (57.4%) from General medicine, 149 (27.2%) from General Surgery, and 84 (15.4%) from Haematology. 130 (23.8%) samples were tested for tuberculosis; the highest yield, acquired from the cervical group (52.8%), lowest from the inguinal region (4%).Conclusions: Our audit revealed significant diagnostic yield of lymph node biopsies from the supraclavicular region. Majority of them were of infectious aetiology and referred from General Medicine. This study supports the introduction of co-ordinated problem-based referral and management pathways for the management of patients with enlarged superficial lymph nodes, supported by regular audits of practice.