Impact of the initial phase of COVID‐19 pandemic on surgical oncology services at a tertiary care center in Eastern India

Abstract

Background The COVID‐19 pandemic has caused a global health emergency and affected the resources in both the public and private health sectors significantly. The present study aims to assess the impact of the pandemic on the services by the department in the first 3 months since the first COVID case in the region. Methods The study period was from 16 March to 15 June 2020. We queried the database for data on site of the tumor, diagnosis, stage, tumor board decisions and planning, surgical procedures, adjuvant treatment, and follow‐up details. The change in tumor board decision and actual treatment taken by the patient were all recorded, taking into consideration the COVID‐19 pandemic. Results Among the 1567 patient contacts, 1306 were out‐patient visits and 261 teleconsultations. Fifty‐four patients underwent surgery from the 87 admitted to the hospital. Ten preoperative patients and two postoperative patients were tested for COVID and reported to be negative. Conclusions The dilemma of providing cancer surgery services to the patients in this pandemic has been global. Strict measures and guidelines can help to overcome the COVID pandemic time, keeping in mind the locoregional logistics.

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

“…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 .…”

“…Shrikhande et al 13 reported outcomes in a large cohort of 494 patients from the same centre albeit performed over a smaller duration of 2 months with a similar incidence of postoperative complications as the present study. In the cohorts reported by Sultania et al 14 and Pai et al, 17 56 procedures and 184 major procedures were done, respectively. The incidence of postoperative complications was again higher than our present study, and one and three cases of mortality were reported, respectively 14,17 .…”

“…In the cohorts reported by Sultania et al 14 and Pai et al, 17 56 procedures and 184 major procedures were done, respectively. The incidence of postoperative complications was again higher than our present study, and one and three cases of mortality were reported, respectively 14,17 . Ramachandra et al 15 describe the outcomes in 359 operated patients from a large centre in south India, with a similar incidence of postoperative complications as our study and one death.…”

Providing cancer patients with COVID‐19 free surgical pathway by two test 7 days apart preoperative protocol (TTS protocol)

“…With this fixed protocol, not even a single patient had turned covid positive (in our department) in the postoperative period, when other departments of the hospital witnessed a number of patients positive for COVID‐19. Despite the state of Odisha, witnessing a surge of COVID‐19 cases in the month August and September, we never discontinued our surgical services (although, operations were reduced in number) at any phase of the pandemic 3 …”

“…In the period between April 1 and November 15, 2020, 146 admissions were made and 95 elective cancer surgeries were performed. Early‐stage patients, patients receiving neoadjuvant therapy and palliative surgery were prioritized 3 . In our department, all out‐patients were screened with a set of questions about respiratory symptoms, travel history and exposure.…”