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. 2023 Aug;25(8):907-914.
doi: 10.1016/j.hpb.2023.04.007. Epub 2023 Apr 15.

Surgical management of primary liver cancers during the COVID-19 pandemic: overcoming the dilemma with standardization

Ali Ramouz  1 , Sanam Fakour  1 , Marzieh Jafari  1 , Elias Khajeh  1 , Mohammad Golriz  2 , Ali Majlesara  1 , Uta Merle  3 , Christoph Springfeld  4 , Thomas Longerich  5 , Markus Mieth  2 , Arianeb Mehrabi  6
Affiliations

Surgical management of primary liver cancers during the COVID-19 pandemic: overcoming the dilemma with standardization

Ali Ramouz et al. HPB (Oxford). 2023 Aug.

Abstract

Background: The present study evaluates the impact of the pandemic on outcomes after surgical treatment for primary liver cancer in a high-volume hepatopancreatobiliary surgery center.

Methods: Patients, who underwent liver resection for primary liver resection between January 2019 and February 2020, comprised pre-pandemic control group. The pandemic period was divided into two timeframes: early pandemic (March 2020-January 2021) and late pandemic (February 2021-December 2021). Liver resections during 2022 were considered as the post-pandemic period. Peri-, and postoperative patient data were gathered from a prospectively maintained database.

Results: Two-hundred-eighty-one patients underwent liver resection for primary liver cancer. The number of procedures decreased by 37.1% during early phase of pandemic, but then increased by 66.7% during late phase, which was comparable to post-pandemic phase. Postoperative outcomes were similar between four phases. The duration of hospital stay was longer during the late phase, but not significantly different compared to other groups.

Conclusion: Despite an initial reduction in number of surgeries, COVID-19 pandemic had no negative effect on outcomes of surgical treatment for primary liver cancer. The structured standard operating protocol in a high-volume and highly specialized surgical center can withstand negative effects, a pandemic may have on treatment of patients.

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Figures

Figure 1
Figure 1
Flowchart and number of patients discussed in interdisciplinary tumorboards, considering the timeframes of the study
Figure 2
Figure 2
Timeline of the study period and effects of the COVID-19 pandemic on our clinic
See this image and copyright information in PMC

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