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2.
N Z Med J ; 135(1556): 23-43, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-2112075

ABSTRACT

AIM: The purpose of this article is to examine disparities in the impact of the COVID-19 pandemic on access to lung cancer diagnosis and access to clinical services between Maori and non-Maori. METHODS: Using national-level data, we examined age-standardised lung cancer registrations, diagnostic procedures (bronchoscopy) and lung surgeries separately by ethnic group for the years 2018-2020, as well as patterns of stage of diagnosis. RESULTS: We found a trend toward a reduction in rates of lung cancer registration in Maori (but not non-Maori/non-Pacific) New Zealanders in 2020 compared to 2018 and 2019, but no apparent shift in the distribution of stage at diagnosis. We found a trend toward a reduction in rates of bronchoscopy for both Maori and non-Maori/non-Pacific patients, with the largest reduction observed for Maori. Rates of lung cancer surgery appeared to have reduced for Maori patients, although this was based on a small number of procedures. CONCLUSIONS: We observed disparities between Maori and non-Maori/non-Pacific patients in lung cancer registration and bronchoscopy as a result of the COVID-19 pandemic.


Subject(s)
COVID-19 , Lung Neoplasms , COVID-19/epidemiology , Humans , Lung , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Native Hawaiian or Other Pacific Islander , New Zealand/epidemiology , Pandemics
3.
Zhongguo Fei Ai Za Zhi ; 25(8): 622-626, 2022 Aug 20.
Article in Chinese | MEDLINE | ID: covidwho-2024389

ABSTRACT

The rapid development and promotion of minimally invasive thoracic surgery represented by video-assisted thoracoscopy surgery has gradually replaced traditional thoracic surgery technique as the primary choice for the treatment of pulmonary nodules, including early lung cancer. With the clinical application of double-lumen bronchial catheters, the realization of one-lung ventilation technology not only provides a solid anesthesia foundation for the popularization of minimally invasive thoracic surgery, but also provides a guarantee for the rapid and smooth implementation of the operation. However, compared with single-lumen bronchial catheters, the diameter of the double-lumen bronchial catheter is thicker, and the tube body is hard and difficult to shape, which brings inconvenience to anesthesia intubation. The bronchial structure is different, and the incidence of dislocation during anesthesia intubation is also high. With the gradual clinical use of video double-lumen tube (VDLT), it has become a hot spot in thoracic surgery in recent years. This article reviews the application and research progress of VDLT in thoracic surgery.
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Subject(s)
Lung Neoplasms , One-Lung Ventilation , Thoracic Surgery , Humans , Intubation, Intratracheal/methods , Lung Neoplasms/surgery , One-Lung Ventilation/methods , Thoracic Surgery, Video-Assisted/methods
4.
BMC Pulm Med ; 22(1): 8, 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-2009383

ABSTRACT

BACKGROUND: Pulmonary blastoma (PB) comprises a rare heterogeneous group of lung tumours typically containing immature epithelial and mesenchymal structures that imitate the embryonic lung tissue and extremely rarely occurs during pregnancy. Although cough and haemoptysis are the most common PB symptoms, they usually indicate other serious pregnancy-related complications. CASE PRESENTATION: The article presents the unusual case of a 22-year-old pregnant woman diagnosed with PB during pregnancy. CONCLUSIONS: PB is characterized by poor prognosis and patients' outcome relies on a rapid diagnosis. Surgery remains the most common and effective treatment. Due to the extreme rarity, the literature contains only single mentions of PB in pregnancy, thus its impact on the course of pregnancy and the developing fetus remains unknown.


Subject(s)
Lung Neoplasms/diagnosis , Pulmonary Blastoma/diagnosis , Cesarean Section , Chemotherapy, Adjuvant/methods , Female , Humans , Infant, Newborn , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Pregnancy , Pulmonary Blastoma/drug therapy , Pulmonary Blastoma/pathology , Pulmonary Blastoma/surgery , Treatment Outcome , Young Adult
5.
BMJ Case Rep ; 15(8)2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1992986

ABSTRACT

We present a rare complication of microwave ablation (MWA) in a male patient in his 80s. His massive pulmonary necrosis and tension pneumothorax required urgent surgery. However, the damage to the lung tissue was too large, deep and fragile. We failed to suture or conduct wedge resection on the lung lesion, so, left upper lobectomy was necessary. Therefore, we suggest that it is probably possible to reduce the frequency and time threshold when performing MWA for the elderly with comorbidities.


Subject(s)
Catheter Ablation , Lung Neoplasms , Aged , Aged, 80 and over , Catheter Ablation/adverse effects , Humans , Lung/diagnostic imaging , Lung/pathology , Lung/surgery , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Microwaves/adverse effects , Necrosis/etiology , Necrosis/surgery , Octogenarians
6.
Medicine (Baltimore) ; 101(32): e30051, 2022 Aug 12.
Article in English | MEDLINE | ID: covidwho-1992408

ABSTRACT

We employed pandemic treatment strategies that we developed at the beginning of the coronavirus disease 2019 (COVID-19) pandemic, and it was not clear whether any adverse results were associated with our strategies. Therefore, we carried out a retrospective study to compare our pandemic treatment strategies with prepandemic protocols to determine whether the strategies used during the high-risk period of COVID-19 were appropriate. The observation period was September 2019 to February 2020. Patients hospitalized from December 2019 to February 2020 were included as an experimental group, and individuals hospitalized from September 2019 to November 2019 were included as a control group. All non-small cell lung cancer patients hospitalized during the observation period were included except for pediatric and obstetric patients, patients younger than 18 years old, and patients admitted only for routine follow-up examinations. Treatment strategies were evaluated based on the prognosis of the different treatment methods, including surgical and nonsurgical treatments and discontinuation of therapy. Survival curves were analyzed using the Kaplan-Meier method. Cox regression analysis was used for multivariate analysis of risk factors for progress-free survival. Propensity score matching was used for clinical characteristics to adjust for selection bias. Therapy discontinuation in the experimental group was significantly higher than in the control group (P < .001). The differences in cancer progression and the number of deaths between the 2 groups were not significant (P = .38 and .13, respectively). For late-stage patients, there were significant differences in nonsurgical treatment and discontinued therapy (P < .001 and < .001, respectively) between the 2 groups, while the cancer progression and death toll differences were not significant (P = .20 and .20, respectively). For early-stage patients, the differences in surgical treatment, discontinued therapy, cancer progression, and death toll were not significant (P = .24, 0.24, 0.61, and 0.49, respectively) between the 2 groups. Multivariate analysis revealed that temporary discontinuation of therapy did not predict poor progress-free survival independently (hazard ratio = 1.007, 95% confidence interval: 0.653-1.552, P = .98). For patients in geographical regions with a high risk for COVID-19 infections, temporarily suspending treatment for late-stage non-small cell lung cancer patients is not likely to significantly impact their prognosis if they can return to treatment within 3 months of discontinuation.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Adolescent , Child , Humans , Lung Neoplasms/surgery , Propensity Score , Retrospective Studies
7.
Lung Cancer ; 172: 127-135, 2022 10.
Article in English | MEDLINE | ID: covidwho-1983621

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has far-reaching collateral health impacts on the ongoing delivery of surgical care worldwide. The current study was designed to analyze the impact of the COVID-19 pandemic on the number of surgeries of general thoracic surgery in Japan. METHODS: Changes in the number of surgeries for total and three representative tumors were analyzed using the National Clinical Database data with reference to the pandemic infection rate and lung cancer screening. RESULTS: In 2020, the number of surgeries in total and for primary lung cancer and mediastinal lung tumor decreased by 4.9, 5.1, and 5.0 %, respectively. Considering the five-year trend towards a 5 % annual increase, there was a potential 10 % decrease in the number of primary lung cancer surgeries. The number of primary lung cancer surgeries bottomed in July 2020 but recovered towards the end of the year. In contrast, the number of metastatic lung tumor surgeries in 2020 increased by 3.2 %, following a similar trend observed over the previous five years. The number of lung cancer screening examinees decreased markedly with the lowest number in May. Our findings indicate that surgical triage had a limited impact on the decrease in primary lung cancer surgeries during the pandemic; rather, the decrease in lung cancer screening, which was a few months preceding, is most likely responsible. CONCLUSIONS: The decrease in primary lung cancer was mainly caused by the decrease in lung cancer screening, indicating that continuing screening is vital even during a pandemic.


Subject(s)
COVID-19 , Lung Neoplasms , Thoracic Surgical Procedures , COVID-19/epidemiology , Early Detection of Cancer , Humans , Japan/epidemiology , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Pandemics
8.
Can J Surg ; 65(4): E496-E503, 2022.
Article in English | MEDLINE | ID: covidwho-1974348

ABSTRACT

BACKGROUND: It is believed that the cessation of normative cancer care services during the COVID-19 pandemic may be resulting in pathologic upstaging and higher long-term mortality rates. We aimed to understand how the pandemic has affected our patients diagnosed with non-small-cell lung cancer (NSCLC). METHODS: We conducted a single-centre retrospective analysis to assess how the COVID-19 pandemic has affected patient referrals, pathologic stage of NSCLC, mortality rates and surgical procedures at our cancer care centre in Ontario, Canada. At our centre, physicians advocated for and followed recommendations that operations in cancer patients should be among the last procedures to be delayed. Patients were included if they were aged 18 years or older, were not receiving palliative care, and had been screened, diagnosed and treated for NSCLC (primary tumours). We compared outcomes between a prepandemic period (January 2019 to February 2020) and a period during the pandemic (March 2020 to February 2021). RESULTS: A total of 695 patients were included for statistical analysis, of whom 650 underwent surgery. There was no statistically significant difference in any of the outcomes of interest between patients seen before (n = 330) and during (n = 320) the pandemic. CONCLUSION: Cancer care services at our centre were maintained during the COVID-19 pandemic, and potential adverse effects on prognosis and survival that have been seen in other countries were avoided. The results inform health care providers how the effects of future pandemics can be blunted by using proactive preservative strategies and surgeon advocacy.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , COVID-19/epidemiology , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Ontario/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2
10.
Zhongguo Fei Ai Za Zhi ; 25(5): 295-302, 2022 May 20.
Article in Chinese | MEDLINE | ID: covidwho-1847419

ABSTRACT

Though the coronavirus disease is still raging in 2021, clinical research on non-small cell lung cancer (NSCLC) did not stop. However, benefiting from advances in lung cancer treatment modality, NSCLC patients have experienced significant improvements in overall survival and quality of life. Currently, research advances on targeted therapy and immunotherapy have together transformed the status of postoperative adjuvant therapy and established a new standard treatment modality for resectable NSCLC. There are equally important research advances in locally advanced and advanced NSCLC, including new treatment modalities, new therapeutic agents, etc., all of which bringing more options for clinical treatment. These therapies will bring changes to NSCLC and will gradually lead to the chronicity of lung cancer in the foreseeable future. Therefore, this paper reviews important studies that will change clinical practice in NSCLC treatment and noteworthy research advances in 2021.
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Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/surgery , Combined Modality Therapy , Humans , Immunotherapy , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Quality of Life
11.
J Surg Oncol ; 126(3): 407-416, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1820895

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered the delivery of surgical care. The purpose of this study was to explore the impact of COVID-19 on care delivery and quality of life (QOL) from the perspectives of lung cancer surgery patients, family caregivers (FCGs), and thoracic surgery teams. METHODS: Patients/FCGs enrolled in a randomized trial of a self-management intervention for lung cancer surgery preparation/recovery were invited to participate in this qualitative study. Patients/FCGs data were collected separately 1-month postdischarge. Interviews were also conducted with thoracic surgery team members. Content analysis approaches were used to develop themes. RESULTS: Forty-one respondents including 19 patients, 18 FCGs, three thoracic surgeons, and one nurse practitioner participated in the study. Patient themes included isolation, psychological distress, delayed/impacted care, and financial impact. FCGs themes included caregiving challenges, worry about COVID-19, financial hardship, isolation, and physical activity limitations. Surgical team themes included witnessing patient/FCG's distress, challenges with telehealth, communication/educational challenges, and delays in treatment. CONCLUSIONS: COVID-19 had a varied impact on care delivery and QOL for lung cancer surgery dyads. Some dyads reported minimal impact, while others experienced added psychological distress, isolation, and caregiving challenges. Surgical teams also experienced challenges in the approach used to provide care.


Subject(s)
COVID-19 , Lung Neoplasms , Aftercare , COVID-19/epidemiology , Humans , Lung Neoplasms/surgery , Pandemics , Patient Discharge , Quality of Life/psychology
12.
Asian J Surg ; 45(8): 1553-1558, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1814136

ABSTRACT

OBJECTIVE: There is limited literature on patients with a history of COVID-19 pneumonia who underwent anatomical lung resection for non-small cell lung cancer (NSCLC). This study was aimed to share the early postoperative outcomes in patients who underwent lung resection after COVID-19 pneumonia. MATERIALS AND METHODS: We retrospectively evaluated 30 patients who underwent lobectomy with thoracotomy and systematic mediastinal lymph node dissection due to NSCLC in a single center between November 2018 and September 2021. The patients were divided into two groups regarding COVID-19 pneumonia history; the COVID-19 group consisted of 14 patients (46.7%) and the non-COVID-19 group 16 (53.3%) patients. The patients' age, gender, comorbidity, Charlson Comorbidity Index (CCI) score, forced expiratory volume in 1 s (FEV1) value, tumor type and size, resection type, postoperative air leak duration, total drainage volume, drain removal time, postoperative complications, and length of stay (LOS) were recorded. RESULTS: 9 (30%) patients were female, and 21 (70%) were male. The mean age was 62.1 ± 8.91 years. Our comparison of postoperative air leak duration, total drainage volume, time to drain removal, postoperative complications, and LOS between the COVID-19 and non-COVID-19 groups revealed no statistically significant difference. CONCLUSION: Anatomical lung resection can be performed safely in NSCLC patients with a history of COVID-19 pneumonia without significant difference in early postoperative morbidity and mortality.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Aged , COVID-19/complications , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/surgery , Female , Humans , Lung/pathology , Lung Neoplasms/complications , Lung Neoplasms/surgery , Male , Middle Aged , Pneumonectomy/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgery , Retrospective Studies , Thoracic Surgery, Video-Assisted/adverse effects
14.
J Thorac Cardiovasc Surg ; 164(2): 378-385, 2022 08.
Article in English | MEDLINE | ID: covidwho-1712841

ABSTRACT

BACKGROUND: The influence of SARS-CoV-2 on surgery for non-small cell lung cancer needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. OBJECTIVE: This study reports on the 90-day rate of infection as well as the morbidity and mortality of lung surgery for cancer in a tertiary care hospital located in a pandemic epicenter. METHODS: We conducted a retrospective review of a prospective database to identify consecutive patients who underwent lung cancer resection before (January 1, 2020-March 10, 2020, group 1; 57 patients) and during the COVID-19 pandemic (March 11, 2020-June 10, 2020, group 2; 41 patients). The primary end point was the occurrence of SARS-CoV-2 infection during the first 90-days after surgery. The secondary outcome measure was 90-day perioperative morbidity and mortality. RESULTS: Patient characteristics were not significantly different between the groups. Ninety-day COVID-19 infection rates was 7.3% (3 out of 41) for patients undergoing an operation during the pandemic and 3.5% (2 out of 57) in patients operated on immediately before the pandemic. All patients tested positive 10 to 62 days after the index surgical procedure following hospital discharge. Four COVID-19-positive patients were symptomatic and 4 out of 5 patients required hospitalization, were men, previous or current smokers with hyperlipidemia, and underwent a sublobar resection. Univariate analysis did not identify any differences in postoperative complications before or during the COVID-19 pandemic. Ninety-day mortality was 5% (2 out of 41) for lung cancer surgery performed during the pandemic, with all deaths occurring due to COVID-19, compared with 0% (0 out of 57) mortality in patients who underwent an operation before the pandemic. CONCLUSIONS: During the COVID-19 pandemic, COVID-19 infections occurred in 7.3% of patients who underwent surgery for non-small cell lung cancer. In this series all infections occurred after hospital discharge. Our results suggest that COVID-19 infections occurring within 90 days of surgery portend a 40% mortality, warranting close postoperative surveillance.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , COVID-19/epidemiology , Carcinoma, Non-Small-Cell Lung/epidemiology , Carcinoma, Non-Small-Cell Lung/surgery , Female , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Male , Pandemics , Retrospective Studies , SARS-CoV-2
15.
J Surg Res ; 274: 213-223, 2022 06.
Article in English | MEDLINE | ID: covidwho-1707290

ABSTRACT

INTRODUCTION: In the current era of episode-based hospital reimbursements, it is important to determine the impact of hospital size on contemporary national trends in surgical technique and outcomes of lobectomy. METHODS: Patients aged >18 y undergoing open and video-assisted thoracoscopic surgery (VATS) lobectomy from 2008 to 2014 were identified using insurance claims data from the National Inpatient Sample. The impact of hospital size on surgical approach and outcomes for both open and VATS lobectomy were analyzed. RESULTS: Over the 7-y period, 202,668 lobectomies were performed nationally, including 71,638 VATS and 131,030 open. Although the overall number of lobectomies decreased (30,058 in 2008 versus 27,340 in 2014, P < 0.01), the proportion of VATS lobectomies increased (24.0% versus 46.9%), and open lobectomies decreased (76.0% versus 53.0%, all P < 0.01). When stratified by hospital size, small hospitals had a significant increase in the proportion of open lobectomies (6.4%-12.2%; P = 0.01) and trend toward increased number of VATS lobectomies (2.7%-12.2%). Annual mortality rates for VATS (range: 1.0%-1.9%) and open (range: 1.9%-2.4%) lobectomy did not significantly differ over time (all P > 0.05) but did decrease among small hospitals (4.1%-1.3% and 5.1%-1.1% for VATS and open, respectively; both P < 0.05). After adjusting for confounders, hospital bed size was not a predictor of in-hospital mortality. CONCLUSIONS: Utilization of VATS lobectomies has increased over time, more so among small hospitals. Mortality rates for open lobectomy remain consistently higher than VATS lobectomy (range 0.4%-1.4%) but did not significantly differ over time. This data can help benchmark hospital performance in the future.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Lung Neoplasms/surgery , Pneumonectomy/methods , Retrospective Studies , Thoracic Surgery, Video-Assisted/methods , Thoracotomy
16.
Swiss Med Wkly ; 152: w30109, 2022 01 31.
Article in English | MEDLINE | ID: covidwho-1687294

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on oncological and thoracic surgical practice worldwide. In many hospitals, the care of COVID-19 patients required a reduction of elective surgery, to avoid viral transmission within the hospital, and to save and preserve personnel and material resources. Cancer patients are more susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and are at an increased risk of a severe course of disease. In many patients with lung cancer, this risk is further increased owing to comorbidities, older age and a pre-existing lung disease. Surgical resection is an important part of the treatment in patients with early stage or locally advanced non-small cell lung cancer, but the treatment of these patients during the COVID-19 pandemic becomes a challenging balance between the risk of patient exposure to SARS-CoV-2 and the need to provide timely and adequate cancer treatment despite limited hospital capacities. This manuscript aims to provide an overview of the surgical treatment of lung cancer patients during the COVID-19 pandemic including the triage and prioritisation as well as the surgical approach, and our own experience with cancer surgery during the first pandemic wave. We furthermore aim to highlight the risk and potential consequences of delayed lung cancer treatment due to the deferral of surgery, screening appointments and follow-up visits. With much attention being diverted to COVID-19, it is important to retain awareness of cancer patients, maintain oncological surgery and avoid treatment delay during the pandemic.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Aged , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Pandemics , SARS-CoV-2
17.
Surg Endosc ; 36(7): 5501-5509, 2022 07.
Article in English | MEDLINE | ID: covidwho-1669809

ABSTRACT

BACKGROUND: Innovations in surgical instruments have made single-port surgery more widely accepted and lead to a reduced demand for surgical assistants. As COVID-19 has ravaged the world, maintaining minimum medical staffing requirements and proper social distancing have become major topics of interest. We sought to evaluate the feasibility of applying the unisurgeon approach in single-port video-assisted thoracoscopic surgery aided by a robotic camera holder. METHODS: Operative time, blood loss, setup time, postoperative hospital stays, and the number of participating surgeons in single-port video-assisted thoracoscopic lung resections were gathered for investigation after the introduction of the ENDOFIXexo robotic endoscope holder system. In this cohort, we collected 213 patients who underwent single port video thoracoscope surgery, including 57 patients underwent robotic endoscope arm assisted surgery and case-matched 52 patients in the robotic arm-assisted group with patients in the human-assisted group through propensity score-matched analysis. RESULTS: In wedge resection, a single surgeon was able to completely operate on all lobes of target lesions. However, for anatomical resections, namely segmentectomy, the success rate was 95%, and for lobectomy, the success rate was only 64%. No significant differences between setup times, blood loss, or operative times between the two groups were observed. CONCLUSIONS: When an experienced uniport surgeon is assisted by a robotic endoscope holder, wedge resection is the most suitable procedure to be performed through unisurgeon single-port video-assisted thoracoscopic surgery without increasing setup time, operative time, or short-term complications. Verification of the technique's applicability for use in anatomic resections requires further investigation.


Subject(s)
COVID-19 , Lung Neoplasms , COVID-19/epidemiology , Endoscopes , Humans , Lung Neoplasms/surgery , Operative Time , Pneumonectomy/methods , Retrospective Studies , Thoracic Surgery, Video-Assisted/methods
18.
Bratisl Lek Listy ; 123(2): 125-128, 2022.
Article in English | MEDLINE | ID: covidwho-1643737

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, some factors have led to changes in the management of patients with lung cancer. In our study, we aimed to present our surgical treatment approach to patients with NSCLC during the COVID-19 pandemic. METHODS: Patients who underwent surgery for NSCLC in our thoracic surgery clinic between March 2020 and March 2021 were evaluated retrospectively. The patients operated on were retrospectively evaluated in terms of sex, age, tumor staging, lung resection type, histopathological type, COVID-19 status, length of stay, complications, and mortality. RESULTS: Thirty-five patients, 27 men and 8 women, underwent surgery for lung cancer. The 2 most common types of surgery were lobectomy (in 32 patients) and pneumonectomy (in 3 patients). According to cancer staging based on 8th TNM, 14 patients were stage 2B, 12 patients were stage 2A, and 9 patients were stage 3A. The morbidity rate was 14 %. No postoperative mortality was observed. Nine patients had a history of COVID- 19 before surgery. No significant difference was found in terms of complications in patients with a preoperative history of COVID-19. In the postoperative period, COVID-19 was observed in no patient in our clinic. CONCLUSION: We think that surgical treatments should not be postponed for diseases such as lung cancer, where the mortality rate is high and early diagnosis and treatment are very important. There will be no delay or inadequacy in the treatment of patients if the rules determined during the COVID-19 pandemic and other types of pandemic possibly occurring in the future are followed (Tab. 1, Ref. 23).


Subject(s)
COVID-19 , Lung Neoplasms , Critical Care , Female , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Neoplasm Staging , Pandemics , Pneumonectomy , Retrospective Studies , SARS-CoV-2
19.
BMJ Open Respir Res ; 9(1)2022 Jan.
Article in English | MEDLINE | ID: covidwho-1627443

ABSTRACT

INTRODUCTION: Exercise is important in the postoperative management of lung cancer, yet no strong evidence exists for delivery of home-based programmes. Our feasibility (phase I) study established feasibility of a home-based exercise and self-management programme (the programme) delivered postoperatively. This efficacy (phase II) study aims to determine whether the programme, compared with usual care, is effective in improving physical function (primary outcome) in patients after lung cancer surgery. METHODS AND ANALYSIS: This will be a prospective, multisite, two-arm parallel 1:1, randomised controlled superiority trial with assessors blinded to group allocation. 112 participants scheduled for surgery for lung cancer will be recruited and randomised to usual care (no exercise programme) or, usual care plus the 12-week programme. The primary outcome is physical function measured with the EORTC QLQ c30 questionnaire. Secondary outcomes include health-related quality of life (HRQoL); exercise capacity; muscle strength; physical activity levels and patient reported outcomes. HRQoL and patient-reported outcomes will be measured to 12 months, and survival to 5 years. In a substudy, patient experience interviews will be conducted in a subgroup of intervention participants. ETHICS AND DISSEMINATION: Ethics approval was gained from all sites. Results will be submitted for publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12617001283369.


Subject(s)
Lung Neoplasms , Self-Management , Exercise , Exercise Therapy/methods , Humans , Lung Neoplasms/surgery , Prospective Studies , Quality of Life , Randomized Controlled Trials as Topic
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