• Annals of surgery · Sep 2020

    Outcomes of Elective Major Cancer Surgery During COVID 19 at Tata Memorial Centre: Implications for Cancer Care Policy.

    • Shailesh V Shrikhande, Prathmesh S Pai, Manish S Bhandare, Ganesh Bakshi, Devendra A Chaukar, Pankaj Chaturvedi, Mahesh Goel, Ashish Gulia, Sajid S Qureshi, Amita Maheshwari, Aliasgar Moiyadi, Sudhir Nair, Nita S Nair, George Karimundackal, Avanish P Saklani, Vinay K Shankhadhar, Vani Parmar, Jigeeshu V Divatia, Pramesh Cs, Ajay Puri, Rajendra A Badwe, and all collaborators from Department of Surgical Oncology.
    • Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Ernest Borges Marg, Parel, Mumbai, India.
    • Ann. Surg. 2020 Sep 1; 272 (3): e249e252e249-e252.

    BackgroundOverburdened systems and concerns of adverse outcomes have resulted in deferred cancer surgeries with devastating consequences. In this COVID pandemic, the decision to continue elective cancer surgeries, and their subsequent outcomes, are sparsely reported from hotspots.MethodsA prospective database of the Department of Surgical Oncology was analysed from March 23rd to April 30th, 2020.FindingsFour hundred ninety-four elective surgeries were performed (377 untested and 117 tested for Covid 19 before surgery). Median age was 48 years with 13% (n = 64) above the age of 60 years. Sixty-eight percent patients were American Society of Anaesthesiology (ASA) grade I. As per surgical complexity grading, 71 (14·4%) cases were lower grade (I-III) and 423 (85.6%) were higher grade complex surgeries (IV - VI).Clavien-Dindo ≥ grade III complications were 5.6% (n = 28) and there were no postoperative deaths. Patients >60 years documented 9.3% major complications compared to 5.2% in <60 years (P = 0.169). The median hospital stay was 1 to 9 days across specialties.Postoperatively, 26 patients were tested for COVID 19 and 6 tested positive. They all had higher grade surgeries but none required escalated or intensive care treatment related to COVID infection.InterpretationA combination of scientific and administrative rationale contributed to favorable outcomes after major elective cancer surgeries. These results support the continuation of elective major cancer surgery in regions with Covid 19 trends similar to India.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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