Performing gynecologic cancer surgery during the COVID‐19 pandemic in Turkey: A multicenter retrospective observational study

Abstract

Objective To report the perioperative outcomes of 200 patients with gynecologic cancer who underwent surgery during the Novel Coronavirus Disease (COVID‐19) pandemic and the safety of surgical approach. Methods Data of patients operated between March 10 and May 20, 2020, were collected retrospectively. Data were statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows v. SP21.0. Results Data of 200 patients were included. Their mean age was 56 years. Of the patients, 54% (n=108), 27.5% (n=55), 12.5% (n=25), and 2% (n=4) were diagnosed as having endometrial, ovarian, cervical, and vulvar cancer, respectively. Of them, 98% underwent non‐emergent surgery. A minimally invasive surgical approach was used in 18%. Stage 1 cancer was found in 68% of patients. Surgeons reported COVID‐related changes in 10% of the cases. The rate of postoperative complications was 12%. Only two patients had cough and suspected pneumonic lesions on thoracic computed tomography postoperatively, but neither was positive for COVID‐19 on polymerase chain reaction testing. Conclusion Based on the present findings, it is thought that gynecologic cancer surgery should continue during the COVID‐19 pandemic while adhering to the measures. Postponement or non‐surgical management should only be considered in patients with documented infection. Gynecologic cancer surgery should continue during the COVID‐19 pandemic while adhering to measures. Only 1% of patients developed COVID‐19‐related symptoms during the postoperative follow‐up period.

Global Prevalence of Perioperative Outcomes of Surgical Patients with COVID-19: A Systematic Review and Meta-Analysis

“…The Meta-Analysis showed that the prevalence of comorbidity among surgical patients was with COVID-19 was 18% (95% CI: 10 to 25) which is in line with the results of included studies (21,23,29,49,90,91,95). The subgroup analysis showed that dementia was the most prevalent comorbidity followed by hypertension and Diabetes Mellitus.…”

“…Body of evidence showed that patients visiting the health institution during the COVID-19 pandemic decrease signi cantly despite requiring medical care which affects signi cantly the non-COVID-19 patients' hospital admission (22)(23)(24)(25)(26).…”

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high (23,25,39,(48)(49)(50) while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures (21,47,51,52).…”

Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

“…Body of evidence showed that patients visiting the health institution during the COVID-19 pandemic decrease signi cantly despite requiring medical care which affects signi cantly the non-COVID-19 patients' hospital admission [29][30][31][32][33].…”

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high [30,32,46,[55][56][57] while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures [28,54,58,59].…”