IMPACT OF THE COVID-19 OUTBREAK ON SURGICAL MANAGEMENT OF MUSCULOSKELETAL ONCOLOGY PATIENTS: A MULTI-CENTER PROSPECTIVE COHORT STUDY
Article Sidebar
Main Article Content
Abstract
Objective: To evaluate the impact of the Covid-19 outbreak on surgical management of musculoskeletal oncology patients.
Methodology: A total of 76 patients were identified and included in this observational study for which data was collected from the databases of Hayatabad Medical Complex, Peshawar & Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan from March till August 2020. Patients having malignant bone and soft tissue tumours and locally aggressive benign tumours were included in this study. All the patients underwent PCR investigation for SARS-CoV-19 virus pre-operatively and surgeries were performed in PCR negative and asymptomatic PCR positive patients only, with protective equipment.
Results: In sample, 8 patients tested positive for Covid-19, out of which 2 were asymptomatic and hence surgery was performed. The remaining 6 were sent for home isolation, of which 2 did not return for surgery. Five patients had ablative surgery due to disruption in medical services whereas the initial plan was for limb salvage surgery. Eight patients developed complications while 2 patients passed away in the post-operative period. None of the patients had any Covid 19 related morbidity or mortality.
Conclusion: The study concluded that only a minute number of patients were suffered due to Covid-19 results. Disruption in services due to Covid-19 outbreak has impacted the efficient delivery of health care in various specialties including serious pathologies like musculoskeletal tumours.
Article Details
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Corona virus from Patients with Pneumonia in China. N Engl J Med. 2019; 82(8):727–33.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteris¬tics of 138 hospitalized patients with 2019 Novel Coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061–1069 https://doi. org/10.1001/jama.2020.1585
Novel Coronavirus (2019-nCoV) situa¬tion reports. [cited 2020 Apr 8]. Avail¬able from: URL: https://www.who.int/ emergencies/diseases/novel-coronavi¬rus-2019/situation-reports
COVID-19 Guidelines for Triage of Can¬cer Surgery Patients. American Col¬lege of Surgeons. [cited 2020 Apr 9]. Available from: URL: https://www.facs. org/covid-19/clinical-guidance/elec¬tive-case/cancer-surgery
COVID-19 Resources. Society of Surgi¬cal Oncology. [cited 2020 Apr 9]. Avail¬able from: URL: https://www.surgonc. org/resources/covid-19-resources/
NCCN covid-19 resources. [cited 2020 Apr 9]. Available from: URL: https:// www.nccn.org/covid-19/theihns.
The Irish Head and Neck Society. theihns. [cited 2020 Apr 9]. Available from: URL: https://theihns.com/covid19
BASO - The British Association of Sur¬gical Oncology: ESSO. [cited 2020 Apr 9]. Available from: URL: https://www. essoweb.org/baso/
Guidelines and Recent Publications. British Gynaecological Cancer Society. [cited 2020 Apr 9]. Available from: URL: https://www.bgcs.org.uk/professionals/ guidelines-for-recent-publications/
Massey PA, McClary K, Zhang AS, Savoie FH, Barton RS. Orthopaedicsur¬gical selection and inpatient paradigms during the coronavirus COVID-19 pan¬demic. J AM Acad Orthop Surg. 2020; 28(11):436-50.
Sahbat Y, Buyuktopcu O, Topkar OM, Erol B. Management of orthopaedicon¬cology patients during coronavirus pan¬demic. J Surg Oncol. 2020; 122:594- 601.
Royal College of Surgeons. Clinical guide to surgical prioritisation during thecoronavirus pandemic. [cited 2020 June 26]. Available from: URL: https:// www.rcseng.ac.uk/coronavirus/surgi¬cal-prioritisation-guidance/..
Stevenson JD, Evans S, Morris G, Till¬man R, Abudu A, Jeys A, et al. Mortality of high- risk orthopaedic oncology pa¬tients during the COVID-19 pandemic: A prospective cohort study. J Surg Oncol. 2020; 10. doi:10.1002/jso.26127.
Chen N, Zhou M, Dong X. Epidemiolog¬ical and clinical characteristics of 99 casesof 2019 novel coronavirus pneu¬monia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507- 13.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adultinpatients with COVID-19 in Wuhan, China: a retro¬spective cohort study. Lancet. 2020; 395(10229):1054-62.
Guo X, Wang J, Hu D. Survery of COVID-19 disease among orthopae¬dicsurgeonsin Wuhan, Peoples republic of China. J Bone Joint Surg Am. 2020; 102:1-854.
Parvizi J, Gehrke T, Krueger CA, Chisari E, CItak M, Van Onsem S, et al. Current concepts review resuming elective or¬thopaedic surgery during COVID-19 pandemic. J Bone Joint Surg Am. 2020; 102(14):1205-1212.
Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19patient needs an operation: operating room prepara¬tion and guidance. Can J Anesth. 2020; 67(6):756-758.