Uniform infection screening allowed safe head and neck surgery during the coronavirus disease 2019 pandemic in Japan

Abstract

Background The purpose of this study was to determine whether a uniform infection screening protocol could be used to safely perform head and neck cancer surgery during the coronavirus disease 2019 pandemic and clarify how surgical treatment changed compared with the pre-pandemic period. Materials and methods During the unprecedented coronavirus disease 2019 pandemic in Tokyo, we continued providing head and neck cancer care, guided by our own uniform screening protocol. In this study, medical records of 208 patients with head and neck malignancy, who underwent surgical treatment at our hospital during the first and second wave of pandemic for each 2-month period (first wave: 30 March 2020–30 May 2020, second wave: 14 July 2020–14 September 2020) and the 2-month pre-pandemic period (30 October 2019–30 December 2020), were analysed. Results A total of 133 patients were admitted for surgical treatment and all, except six patients with emergency tracheostomy, were screened according to the protocol. As a result, all 127 patients received surgical treatment as planned, and all 1247 medical staff members involved in the surgeries were uninfected by severe acute respiratory syndrome coronavirus 2. During the first wave of pandemic, 20% reduction of head and neck surgery was requited; however, restrictions of surgery were not necessary during the second wave. Surgical procedure, length of hospitalization, postoperative complications and number of medical staff were unchanged compared with pre-pandemic period. Conclusion Our data indicate that continuation of head and neck anticancer surgical treatment in an epidemic area during the coronavirus disease 2019 pandemic were safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out.

Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic

“…The results of this study are in concordance with the data from most other centres 18 , 19 , which clearly show that the postoperative outcomes remain unchanged with no added risk or a minimal risk of SARS-CoV-2 infections in healthcare personnel. Iyer et al reported that there was a reduction in number of cases (overall operative caseload) to about 60% of the pre-COVID-19 times in order to maintain adequate safety and implement protective measures for COVID-19 transmission 20 .…”

Outcomes of head and neck cancer management from two cancer centres in Southern and Northern Europe during the first wave of COVID-19

“…40 Performing a preoperative nasopharyngeal swab in all patients with HNC was done to reduce the possibility of perioperative complications and to keep hospitals safe for other patients and staff. [41][42][43] HNCs arise from mucosal membranes and the diagnosis and treatment often involve potential viral exposure, dysphagia or airway compromise, and nasogastric or tracheotomy tubes, all factors potentially exposing health care providers to aerosolized virus. 41,44 In this scenario, social distancing and personal hygiene are mandatory to avoid spread of COVID-19.…”

Trends of Microsurgical Head and Neck Free Flap Reconstruction and Safety during the COVID-19 Pandemic

“…In fact, studies have shown that with an appropriate screening process and postoperative care, these elective procedures can be performed safely during the current pandemic while minimizing delays in treatment. [28][29][30][31] Furthermore, it could be then reasonable to infer that due to the massive elective surgeries' cancellations secondary to the COVID-19 pandemic, delays in diagnosis and treatment, as well as a surge of advanced HN cancer are anticipated. [32][33][34] Moreover, Kiong et al, in a retrospective review, evidenced an increased tumor burden in patients with HN malignancies, despite having similar time of diagnosis.…”

“…In fact, studies have shown that with an appropriate screening process and post-operative care, these elective procedures can be performed safely during the current pandemic while minimizing delays in treatment. [28][29][30][31] This article is protected by copyright. All rights reserved.…”