Perspectives in surgical and anaesthetic management of lung cancer in the era of coronavirus disease 2019 (COVID-19)

Abstract

Early in 2020, coronavirus disease 2019 (COVID-19) quickly spread globally, giving rise to a pandemic. In this critical scenario, patients with lung cancer need to continue to receive optimal care and at the same be shielded from infection with the potentially severe acute respiratory syndrome coronavirus 2. Upgrades to the prevention and control of infection have become paramount in order to lower the risk of hospital contagion. Aerosol-generating procedures such as endotracheal intubation or endoscopic procedures may expose health care workers to a high risk of infection. Moreover, thoracic anaesthesia usually requires highly complex airway management procedures because of the need for one-lung isolation and one-lung ventilation. Therefore, in the current pandemic, providing a fast-track algorithm for scientifically standardized diagnostic criteria and treatment recommendations for patients with lung cancer is urgent. Suggestions for improving existing contagion control guidelines are needed, even in the case of non-symptomatic patients who possibly are responsible for virus spread. A COVID-19-specific intraoperative management strategy designed to reduce risk of infection in both health care workers and patients is also required.

The impact of the COVID‐19 pandemic on care delivery and quality of life in lung cancer surgery

“…Importantly, surgical teams also experienced challenges in the approach used to provide care. 8 , 23 , 28 As the pandemic continues to evolve, further observational research is needed to evaluate the impact of COVID‐19 on dyads' psychological wellbeing, level of preparation for lung cancer surgery, shared treatment decision‐making, financial distress/toxicity, and delays in screening/diagnosis/treatment. The expansion of telehealth in thoracic surgery will continue to change the care delivery landscape, and future studies should identify best practices in the use of telehealth that is least burdensome with high benefits for patients, FCGs, and thoracic surgery teams.…”

COVID-19 Pandemic: Advances in Diagnosis, Treatment, Organoid Applications and Impacts on Cancer Patient Management

“…The establishment of COVID-19-free surgical pathways, which provides elective surgery, critical care, and inpatient ward care with no shared areas with COVID-19 patients, is paramount during COVID-19 pandemic ( 142 ). Of note, Silvia Fiorelli et al highlighted the importance that lung cancer patients should continue to receive prompt surgical treatment, and upgraded management strategy is needed for the surgical treatment, patient selection and perioperative management ( 143 ). Based on appropriate patient screening and improved precautions, no COVID-19 positive cases were recorded among the medical staff or the hospitalized patients during their hospital stay.…”

“…Based on appropriate patient screening and improved precautions, no COVID-19 positive cases were recorded among the medical staff or the hospitalized patients during their hospital stay. Their high-volume thoracic surgery center has successfully maintained safe surgical treatment for lung cancer patients ( 143 ). For cancer patients with COVID-19 coinfection, whether to continue antitumor therapy is still controversial.…”

Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus

“…All depicted societies embedded the proposed triage guidelines either directly or by reference in their recommendations [51] (Figure 2). However, a huge number of elective surgical procedures already have been canceled or postponed, risking untreated or inappropriately treated lung cancer [52]. Therefore, constant reevaluation of patient selection guidelines and differential diagnosis for benign entities are necessary to accurately select patients undergoing lung cancer surgery and ensure a rapid diagnostic and therapeutic process.…”