Thoracic Oncologic Surgery in Covid-19 Pandemic: Short Term Outcomes

Abstract

Objective: After sustained community spread of Coronavirus Disease - 19 (COVID-19), guidelines regarding safe practice are still evolving. In this article, we evaluated our clinic's oncologic thoracic surgery practice in COVID-19 pandemic via an observational retrospective study. Methods: All cases (including local anesthesia only), were recorded in the hospital electronic medical record system. Patients undergoing procedures for cancer related causes (resection, diagnosis, palliation, treatment facilitation) were retrospectively identified. Patient demographic data, type of operation/procedure, 30 day SARS-COV-2 PCR test data, hospital readmission due to COVID-19, 30 and 90 day mortality were gathered. Group 1 and 2 were operated between 1 June 2019 - 11 March 2020 and 12 March 2020 - 31 December 2020, respectively. Results: 344 (Group 1= 178, Group 2= 166) patients underwent thoracic surgery due to cancer related causes during the study period. Surgical or COVID-19 related mortality were not encountered in either group. After initiation of mandatory testing, 3 asymptomatic patients were found to be PCR positive and had surgery rescheduled (2 lung resections, 1 mediastinoscopy). Number of lung resection cases increased postCOVID-19 (25 vs 45, p<0.001). None of the postoperative patients experienced PCR conversion. Conclusion: Safe elective thoracic surgery practice is possible via following basic safety precautions and following evolving national guidelines. Even though routine preoperative SARS-COV-2 PCR testing catches asymptomatic cases that can cause mortality/morbidity for patients and staff, social distancing and other infection control measures have to be in place to prevent in hospital and post-operative SARS-COV-2 PCR conversion.