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Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre.
Leung, Elaine; Pervaiz, Zahra; Lowe-Zinola, Jack; Cree, Sian; Kwong, Audrey; Marriott, Natalie; Cole, Florence; Arum, Uchechukwu; Szopinski, Barbara; Elattar, Ahmed; Sundar, Sudha; Kehoe, Sean; Singh, Kavita; Balega, Janos; Yap, Jason.
  • Leung E; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom.
  • Pervaiz Z; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Lowe-Zinola J; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Cree S; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Kwong A; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Marriott N; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Cole F; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Arum U; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Szopinski B; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Elattar A; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Sundar S; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom.
  • Kehoe S; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom.
  • Singh K; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Balega J; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
  • Yap J; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom. Electronic address: j.yap@bham.ac.uk.
Gynecol Oncol ; 160(3): 649-654, 2021 03.
Article in English | MEDLINE | ID: covidwho-978461
ABSTRACT

BACKGROUND:

Surgery is the cornerstone of gynecological cancer management, but inpatient treatment may expose both patients and healthcare staff to COVID-19 infections. Plans to mitigate the impact of the COVID-19 pandemic have been implemented widely, but few studies have evaluated the effectiveness of these plans in maintaining safe surgical care delivery.

AIM:

To evaluate the effects of mitigating plans implemented on the delivery of gynecological cancer surgery during the COVID-19 pandemic.

METHODS:

A comparative cohort study of patients treated in a high-volume tertiary gyneoncological centre in the United Kingdom. Prospectively-recorded consecutive operations performed and early peri-operative outcomes during the same calendar periods (January-August) in 2019 and 2020 were compared.

RESULTS:

In total, 585 operations were performed (296 in 2019; 289 in 2020). There was no significant difference in patient demographics. Types of surgery performed were different (p = 0.034), with fewer cytoreductive surgeries for ovarian cancer and laparoscopic procedures (p = 0.002) in 2020. There was no difference in intra-operative complication rates, critical care admission rates or length of stay. One patient had confirmed COVID-19 infection (0.4%). The 30-day post-operative complication rates were significantly higher in 2020 than in 2019 (58 [20.1%] versus 32 [10.8%]; p = 0.002) for both minor and major complications. This increase, primarily from March 2020 onwards, coincided with the first peak of the COVID-19 pandemic in the UK.

CONCLUSIONS:

Maintaining surgical throughput with meticulous and timely planning is feasible during the COVID-19 pandemic but this was associated with an increase in post-operative complications due to a multitude of reasons.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gynecologic Surgical Procedures / Delivery of Health Care / Surgical Oncology / COVID-19 / Genital Neoplasms, Female / Gynecology Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Middle aged Country/Region as subject: Europa Language: English Journal: Gynecol Oncol Year: 2021 Document Type: Article Affiliation country: J.ygyno.2020.12.013

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gynecologic Surgical Procedures / Delivery of Health Care / Surgical Oncology / COVID-19 / Genital Neoplasms, Female / Gynecology Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Middle aged Country/Region as subject: Europa Language: English Journal: Gynecol Oncol Year: 2021 Document Type: Article Affiliation country: J.ygyno.2020.12.013