Background
Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission.
Methods
This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days.
Results
A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%. The length of stay (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.04–1.11;
p
< 0.001), surgical time (OR 1.004; 95% CI 1.001–1.008;
p
= 0.023), intensive care unit admission (OR 7.7; 95% CI 2.03–29.28;
p
= 0.003), and hospital readmissions (OR 9.56; 95% CI 2.50–36.56;
p
= 0.001) were associated with postoperative coronavirus disease (COVID-19). Using unadjusted and adjusted logistic regression, length of stay (OR 1.08; 95% CI 1.04–1.11;
p
< 0.001), and readmission (OR 9.02; 95% CI 2.30–35.48;
p
= 0.002) were independent factors of postoperative COVID-19.
Conclusions
Screening patients preoperatively may reduce in-hospital SARS-CoV-2 transmission. Length of stay and readmission were independently correlated with postoperative COVID-19.
Methods It is a retrospective study. We included all patients diagnosed, at our institution, during a 12-year-period (2010-2021), with invasive vulvar cancer. We collected the data regarding the epidemiological, clinical, imaging, pathological, oncological management strategies and outcomes. Results We included 65 patients of whom 89% were menopausal at the time of diagnosis. The average age is 65 years . A history of lichen was reported in 20% of patients, and 5% had vitiligo. The comorbidity rate was 45.8%. The main symptom was vulvar pruritus in 94%. A vulvar lump was reported in 50%of cases. Inguinal lymph nodes were present in 39.21% of cases. Among the 65 patients, 2 patients were metastatic. All patients had vulvar surgery (vulvectomy 89%) and inguinal lymph node dissection (blue dye sentinel lymph node detection rate was 65%). The mean postoperative hospital stay was 24 days . The postoperative complication rate was 39% of whom 66% are infectious complications. 17% had radiotherapy within 12 months after the surgery. The 3 year recurrence rate is 14%. Conclusions Vulvar cancer in Tunisia is mainly a menopausal women's burden characterized by its late diagnosis and the perioperative complication of oncological surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.