Hybrid transthoracic oesophagectomy due to carcinoma with complications after COVID-19 pneumonia – A case report

Abstract

Introduction and importance This case report describes postoperative complications in a patient after hybrid oesophagectomy for oesophageal carcinoma after COVID pneumonia. The global COVID-19 pandemic affected cancer patients indicated for surgery. Covid 19 may worsen the results of oesophageal cancer surgery. More similar studies are needed. Case presentation A 69-year-old male was diagnosed with squamous cell carcinoma of the middle oesophagus based on PET/CT without disease generalisation. His stenotic tumour required a nutritive jejunostomy, with subsequent neoadjuvant radiochemotherapy indicated according to the CROSS protocol. The patient developed COVID pneumonia during the cancer therapy. After managing the COVID pneumonia, oncological therapy was completed and a hybrid oesophagectomy was performed 8 weeks later. Serious complications (respiratory failure, septic shock, anastomosis dehiscence) developed during the postoperative period. All complications were managed therapeutically. The patient was type IVb according to the Clavien-Dindo classification. Clinical discussion Postoperative complications may develop in any patient operated for oesophageal carcinoma, especially if high-risk predictive factors are present. The question arises as to how much the post-COVID condition affected the onset of these serious complications. Conclusion Post-COVID patients are at a risk of developing post-COVID syndrome, which may lead to a wide range of symptoms in the affected organs. Further studies on the relationship between COVID-19 and oesophagectomy for oesophageal carcinoma will be necessary to clarify the relationship between the complications during the postoperative period in patients with oesophageal malignancy.

COVID-associated complications after reconstructive breast surgery: a retrospective cohort study

“…For oncological surgery a few case series described heightened risks for postoperative complications including impaired wound and anastomotic healing in COVID-positive patients as well [ 28 , 29 ]. Similarly, unusual cases of wound dehiscence have been described in pressure ulcer surgery with local reconstruction.…”

Association of major postoperative wound and anastomotic complications in thoracic surgery with COVID-19 infection

“…Dehiscence required surgical revision and drainage. The patient stayed 56 days in the hospital [ 15 ]. In this study, patient D developed massive postoperative bleeding from thoracotomy wound.…”

COVID-associated complications after reconstructive breast surgery – a retrospective cohort study

“…For oncological surgery a few case series described heightened risks for postoperative complications including impaired wound and anastomotic healing in COVID-positive patients as well [28,29]. Similarly, unusual cases of wound dehiscence have been described in pressure ulcer surgery with local reconstruction.…”