Establishing a Universal RT-PCR Testing System Is Essential for the Safe Performance of Scheduled Surgeries During the COVID-19 Pandemic in Japan: A Retrospective Study

Abstract

Background Elective orthopedic surgery, as well as the procedures of many surgical departments, have been severely curtailed by coronavirus disease 2019. Here, we aimed to analyze how all surgeons could safely perform essential procedures during the coronavirus disease 2019 pandemic. Methods A retrospective review of elective surgeries performed between May 15, 2020, and February 28, 2022, was conducted. A screening questionnaire was used, and reverse transcription-polymerase chain reaction testing was assessed in all admitted surgical department patients. Their positivity rate and the positivity rate in our fever outpatient clinic were analyzed. Results Of 6099 patients who tested for severe acute respiratory syndrome coronavirus-2 during the study period, eight (0.13%) tested positive. The positive results were seen in four patients undergoing orthopedic surgery, two undergoing respiratory surgery, one undergoing breast surgery, and one undergoing plastic surgery. The number of patients who visited the outpatient clinic for fever was 15,639, including 1640 positive cases (positive rate of 10.5%). The positive rate of preoperative reverse transcription-polymerase chain reaction testing for scheduled surgery was consistently low and did not coincide with the peak of the wave of infection, while the positivity rate of outpatients with fever demonstrated a wave consistent with the national infection situation. All 6091 patients, excluding the eight positive patients, underwent surgery; all patients who underwent surgery were discharged from the hospital without developing coronavirus disease 2019 symptoms. Conclusions Our findings suggest that the establishment of a universal reverse transcription-polymerase chain reaction testing system is essential for the safe performance of scheduled surgeries during the coronavirus disease 2019 pandemic.