Gynecologic cancer surgery during COVID-19 pandemic: Is it safe ?

ABSTRACT

Introduction/Background:After WHO declared Covid-19 as a pandemic, many scientific organizations, including gynecological oncology and gynecological surgery associations, made new recommendations for treatment protocols for certain diseases. Gynecological cancer surgery could not be performed in many hospitals and medical centers , as they could not provide optiamal conditions for their patients and staff. In this process, our hospital, which was a comprehensive cancer center, was defined as Covid-19 free hospital and established as a reference for other institutions regarding priority oncological surgeries by the regional healthcare authorities. Methodology The data of the patients who were operated with the diagnosis of gynecological cancer between March 1, 2020 and March 1, 2021 were scanned through files. Demographics, comorbidities, surgical type, complications and COVID-19 status were reviewed. Statistical analyzes were performed using the SPSS 22.0 (Statistical Program Social Sciences) package program. The study was approved by the ethical committee the Institutional Review Board of Dr. AY Ankara Oncology Training and Research Hospital and the Ministry of Health Scientific Research Platform. Result(s) The study included a total of 74 patients. Mean age was 58 years (range 16-85). Patients were referred with endometrial (32/74, 43,2%), ovarian (36/74, 48,6%), cervical (5/74, 6,8%), or vulvar cancer (1/74, 1,4). All of the patients underwent open-route laparotomy. Mean hospital stay was 12 days (range 6-51). 13 patients had a postoperative complication (13/74, 17,6%). 8 patients tested positive for COVID-19 following a Polymerase Chain Reaction(PCR) test, in the postoperative period, after discharge . PCR test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-COV- 2) was conducted in 73%. The Covid-19 PCR test has been routinely applied 48 hours before the operation, according to the guidelines published by health authorities since June 2021. Conclusion There is no 'one size fits all' approach to cancer treatment during the COVID-19 pandemic, and there are no international guidelines. Screening and treatment decisions should often be made on a case-by-case basis and often depend on the COVID-19 situation in a single community and the availability of resources. Our study results shows that it can be done safely, even in the pandemic, when strict adherence to Covid 19 precautions for both patients and healthcare workers.