Optimising Cancer Surgery During COVID-19: Experience of Tertiary Cancer Centre in Eastern India

Das, Rekha; Nahak, Snigdha Rani; Parija, Jita; Das, Prafulla K.; Sarangi, Lalatendu; Devi, Padmalaya; Pathy, Pramod C.

PURPOSE: The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. METHODS: We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. RESULTS: A total of 457 surgeries were done—complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I–IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0–3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1–6) days, and length of hospital stay was 7 (7–15) days. Clavien–Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% (p = 0.76). 10% in ASA I compared to 26% of ASA II (p = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 (p = 0.01) had grade II complication. Four (1%) patients had Grade ≥ III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. CONCLUSIONS: Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.