A cohort study of 30 day mortality after NON-EMERGENCY surgery in a COVID-19 cold site

Abstract

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Successful maintenance of process and outcomes for oesophageal cancer surgery in Ireland during the first wave of the COVID-19 pandemic

“…As we report herein, all patients had pre-operative PCR testing and selective CT thorax, and there was no postoperative COVID-19 infection during their inpatient stay. This reflects international experience [ 10 , 24 , 25 ] and suggests that continuing to provide urgent surgical oncology care is safe with a number of simple precautions. As services resume, it may be necessary to strengthen the public–private links to attenuate possible impaired access and surgical delays in the public system.…”

“…Based on the evidence, and common sense, having designated COVID-19 'low-risk' hospitals where possible, universal patient perioperative PCR screening and judicious use of personal protective equipment can mitigate the impact of COVID-19 cases on elective operating lists [10,18,19,[21][22][23]. The low-risk COVID-19 hospital or environment is supported as being effective in a large recent study of 500 patients where only 2% of patients developed COVID-19 in the perioperative period [24]. In Ireland, through the Government response to the national emergency, and agreement from all key stakeholders involving contracts with private hospitals, patients requiring oesophageal cancer surgery in designated COVID-19 hospitals were in some cases relocated to private hospitals which were relatively low risk for COVID-19, and where access to ICU was not a barrier to delivery care in a timely manner.…”

Safety of “hot” and “cold” site admissions within a high‐volume urology department in the United Kingdom at the peak of the COVID‐19 pandemic

“…This is a worldwide phenomenon with up to 2.8 million surgeries worldwide expected to be delayed canceled as a result of COVID‐19, making it vital to find a safe method of carrying out operations following the pandemic 12 . The “cold” site model has been safely described elsewhere, and reports from another “cold” site in London have reported a 2% rate of postoperative COVID‐19 infection, with only 0.2% of their cohort reporting Clavien‐Dindo grade 3 complications related to COVID‐19 13 . While the “cold” site was not associated with a reduction in COVID‐19 infection when compared to the “hot” site (OR 0.86, 95% CI 0.25‐3.01) it did allow the center described to continue complex important operations safely at the peak of the pandemic.…”

“…London have reported a 2% rate of postoperative COVID-19 infection, with only 0.2% of their cohort reporting Clavien-Dindo grade 3 complications related to COVID-19 13. While the "cold" site was not associated with a reduction in COVID-19 infection when compared to the "hot" site (OR 0.86, 95% CI 0.25-3.01) it did allow the center described to continue complex important operations safely at the peak of the pandemic.…”

Evaluating the feasibility of performing elective gastrointestinal cancer surgery during the COVID‐19 pandemic: An observational study with 60 days follow‐up results of a tertiary referral pandemic hospital

“…Moreover, in line with increasing recommendations from prominent surgical associations about triage and the management of cancer patients to mitigate the exposure to COVID‐19, the treatment programs were rescheduled, resulting in a paradigm shift in the treatment of patients with precancerous lesions, early‐stage or uncomplicated cancers 1–6 . However, concerning that short‐term surgical delays may result in unpredictable negative outcomes even in the early stages of cancer, irrespective of their surgical branch, every specialist focused on finding a way to ensure their accustomed oncological practice while dealing with an enemy that was never faced before 7,8 …”