Myths of surgery and ‘The Pandemic’: A Surgeons Dilemma

Author(s): Abdul Rehman, Muhammad Fahd Shah, Muhammad Toqeer Zahid, Hamza Shahid, Verda Baig, Masood Ur Rehman, Shahid Khattak, Aamir Ali Syed

Objective: To study the outcomes of patients who underwent surgery for malignancies during the COVID 19 Pandemic.

Method: Patients who underwent oncological surgery from March to July 2020 were studied. COVID-PCR was done in all patients preoperatively. Those who tested positive were postponed for 2 weeks. Patients were followed for type of surgery, need of ICU admission, presence of COVID symptoms post operatively and development of complications. Total length of hospital stay was also recorded.

Results: A total of 1105 patients were operated from March to July 2020 for GI, HBP, Head & Neck, Urology, Gynaecological, Orthopaedics, Neurosurgical, Plastic Surgery and Cardio-thoracic cancers. Of these 339 patients were operated without any COVID testing. From April 2020, new hospital policies came into effect and every patient was required to undergo testing 48 hours before surgery. 766 patients underwent testing for COVID. 666 patients were negative and proceeded with surgery. 92 patients tested positive on routine screening and had their operation delayed for a period of 2 weeks. 8 patients who were operated in emergency had COVID infection but surgery was not delayed due to emergent nature of the procedure. When analysing the hospital stay of these 100 patients who tested positive there were only 10 patients who were admitted to COVID facility and there were only 3 mortalities that were attributable to COVID.

Conclusions: Operating on patients who are COVID positive didn’t lead to any additional morbidity and mortality. We recommend that all hospitals should resume their elective surgical lists.

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