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Comparative Study
. 2021 Mar;160(3):649-654.
doi: 10.1016/j.ygyno.2020.12.013. Epub 2020 Dec 16.

Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre

Elaine Leung  1 , Zahra Pervaiz  2 , Jack Lowe-Zinola  2 , Sian Cree  2 , Audrey Kwong  2 , Natalie Marriott  2 , Florence Cole  2 , Uchechukwu Arum  2 , Barbara Szopinski  2 , Ahmed Elattar  2 , Sudha Sundar  1 , Sean Kehoe  1 , Kavita Singh  2 , Janos Balega  2 , Jason Yap  3
Affiliations
Comparative Study

Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre

Elaine Leung et al. Gynecol Oncol. 2021 Mar.

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.

Keywords: COVID-19; Pandemic; cancer surgery; surgical morbidityvirus.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Mitigation plans undertaken to deliver gynecological cancer surgery during the COVID-19 pandemic.
Fig. 2
Fig. 2
Thirty-day post-operative complication rates in 2019 (n = 32) and 2020 (n = 58) by the type of complications.
Fig. 3
Fig. 3
Thirty-day post-operative complication rates in 2019 (n = 32) and 2020 (n = 58) by calendar month. Only complete calendar months were included in this analysis.
See this image and copyright information in PMC

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