Cancer care in a Western Indian tertiary center during the pandemic: Surgeon's perspective

Abstract

Introduction: Following the nationwide lockdown in India, most hospitals shut down elective surgeries including cancer surgeries. We continued operating on patients with cancer at a tertiary referral center in Western India, which also served as a COVID care center. We also constructed a questionnaire, exclusive to surgeons, to determine the changes in treatment strategies as well as the response to the pandemic. Methods: The complications of all cases operated in the study period (March 22, 2020-June 30, 2020) were graded using the Clavien-Dindo classification. Also, an anonymous structured questionnaire was constructed and e-mailed to all surgical oncologists working at our institute. Results: Of the 118 patients having an operation, 18 had complications. There were 12 Grade I/II and 6 Grade III complications but none of our patients had Grade-IV/V complications. When the staff of the main operating theater tested COVID positive, the complex was shut down. However surgical oncology work continued at an affiliated institute about 10 km away from the main hospital. Conclusion: We had favorable outcomes while operating on cancer patients in a COVID care center. The results of our questionnaire proved that surgeons were willing to risk their personal safety to provide surgical oncology care.

The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic

“…Overall, 75% [c.i. 49%-95%, I 2 99%, number of studies: 10 ( 22 , 25 , 26 , 32 , 36 , 40 , 44 , 45 , 51 , 52 )] of studies reported delay of clinic visits. Stratification according to specialty seemed to show a lower proportion of visits delay in the surgery subgroup, but with only one study belonging to this subgroup.…”

“…PPE were routinely used by workers in 80% [c.i. 61%-94%, I 2 99%, number of studies: 16 ( 18 , 26 , 31 , 33 – 35 , 37 – 39 , 44 , 52 , 53 , 59 , 61 , 63 , 65 )] of cases. No moderator was alone able to explain the true heterogeneity.…”

Continuing cancer surgery through the first six months of the COVID‐19 pandemic at an academic university hospital in India: A lower‐middle‐income country experience

“…In our study, the incidence of Grades II and III complications in the present scenario, as opposed to more Grades I and II complications in the previous year, maybe due to an attempt by the surgeons to intervene on the complications to facilitate early discharge. Interestingly, in the studies from Tata Memorial Hospital 13 and Ruby Hall Clinic, 19 there were no postoperative deaths.…”

“…Several tertiary level academic oncology centres from India have reported their experiences of cancer surgery during the pandemic 13‐19 . India's largest oncology centre was reported to have a decrease in operated cases by a third 20 .…”

COVID‐19 infection and its consequences among surgical oncology patients: A systematic analysis, meta‐analysis and meta‐regression

“…A vital point worth highlighting is the mental burden on health care providers during the COVID‐19 pandemic. Authors have reported that surgeons and other providers face several types of burdens and challenges during the pandemic, including but not limited to the mental strain of not being able to operate, financial loss, social isolation, and burnout 48–50 . Unfortunately, these factors may have contributed to increasing suicide rates among health care providers 51 …”