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Observational Study
. 2021 Sep;28(9):4816-4826.
doi: 10.1245/s10434-021-09885-0. Epub 2021 Apr 17.

Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

Mohamed Alasmar  1   2 , Afsana Kausar  1 , Alexander Berend-Jan Borgstein  3 , Johnny Moons  4 , Sophie Doran  5 , Stefano de Pascale  6 , Rafael Restrepo  7 , Apollonia Verrengia  8 , Mariella Alloggio  9 , Ana Moro Delgado  10 , Sacheen Kumar  5 , Ismael Díez Del Val  10 , Simone Giocapuzzi  9 , Gian Luca Baiocchi  8 , Marta de Vega Irañeta  11 , Gabriel Salcedo  7 , Peter Vorwald  7 , Uberto Fumagalli Romario  6 , Philippe Nafteux  4 , Suzanne Gisbertz  3 , Mohammed Asif Chaudry  5 , Bilal Alkhaffaf  12   13
Affiliations
Observational Study

Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

Mohamed Alasmar et al. Ann Surg Oncol. 2021 Sep.

Abstract

Introduction: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery.

Patients and methods: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group.

Results: In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19.

Conclusions: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Population impacts of COVID-19 during our study period on A intensive care occupancy, B hospital occupancy and C deaths
See this image and copyright information in PMC

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