COVID-19 and the impact on oncological general surgery at a district general hospital

ABSTRACT

Introduction: Covid-19 has had a significant impact on all aspects of healthcare. We aimed to characterise our experience of oncological general surgery during the first 4-months of the pandemic and compare with the same period in 2019. Method: A prospective cohort study was performed from 23/03/20 to 08/ 07/20. All elective oncological operations were included. Data on patient demographics, waiting times, inpatient characteristics and oncological outcomes were recorded. Statistical analysis was used to compare with retrospective data from 2019. Results: 78 patients were included in total, 38 in 2019 and 40 in 2020. There were no differences in length of stay (2.5 vs 3.5 days, p=0.355) or waiting list time (27.2 vs 24.2 days, p=0.574). Oncological outcomes were comparable with no statistical difference in clear resection margin status (94.4 vs 84.6%, p=0.168) or positive nodal status (24.1 vs 37.1%, p=0.298). The percentage of staging CT scans requested externally was higher in 2020 (4 vs 32%, p=<0.05). There was no difference in time from urgent referral to first assessment (30.5 vs 26.4 days, p=0.384) or time to operation (96.6 vs 85.7 days, p= 0.618). Conclusions: Oncological surgery during Covid-19 can be performed safely with favourable oncological outcomes. The longer-term effects from delayed diagnoses remain to be evaluated.