IMPACT OF THE COVID-19 OUTBREAK ON SURGICAL MANAGEMENT OF MUSCULOSKELETAL ONCOLOGY PATIENTS: A MULTI-CENTER PROSPECTIVE COHORT STUDY

Main Article Content

Zeeshan Khan
Badar Uddin Sahito
Muhammad Arif Khan

Abstract

Objective: To evaluate the impact of the Covid-19 outbreak on surgical management of musculoskeletal oncology patients.


Methodology: A total of 76 patients were identified and included in this observational study for which data was collected from the databases of Hayatabad Medical Complex, Peshawar & Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan from March till August 2020. Patients having malignant bone and soft tissue tumours and locally aggres­sive benign tumours were included in this study. All the patients underwent PCR investigation for SARS-CoV-19 virus pre-operatively and surgeries were performed in PCR negative and asymptomatic PCR positive patients only, with protective equipment.


Results: In sample, 8 patients tested positive for Covid-19, out of which 2 were asymptomatic and hence surgery was performed. The remaining 6 were sent for home isolation, of which 2 did not return for surgery. Five patients had ablative surgery due to disruption in medical services whereas the initial plan was for limb salvage surgery. Eight patients developed complications while 2 patients passed away in the post-operative period. None of the patients had any Covid 19 related morbidity or mortality.


Conclusion: The study concluded that only a minute number of patients were suffered due to Covid-19 results. Disruption in services due to Covid-19 outbreak has impacted the efficient delivery of health care in various spe­cialties including serious pathologies like musculoskeletal tumours.

Article Details

How to Cite
1.
Khan Z, Badar Uddin Sahito, Muhammad Arif Khan. IMPACT OF THE COVID-19 OUTBREAK ON SURGICAL MANAGEMENT OF MUSCULOSKELETAL ONCOLOGY PATIENTS: A MULTI-CENTER PROSPECTIVE COHORT STUDY. J Postgrad Med Inst [Internet]. 2021 Sep. 30 [cited 2022 May 21];35(3):162-8. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/2899
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References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Corona virus from Patients with Pneumonia in China. N Engl J Med. 2019; 82(8):727–33.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteris¬tics of 138 hospitalized patients with 2019 Novel Coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061–1069 https://doi. org/10.1001/jama.2020.1585

Novel Coronavirus (2019-nCoV) situa¬tion reports. [cited 2020 Apr 8]. Avail¬able from: URL: https://www.who.int/ emergencies/diseases/novel-coronavi¬rus-2019/situation-reports

COVID-19 Guidelines for Triage of Can¬cer Surgery Patients. American Col¬lege of Surgeons. [cited 2020 Apr 9]. Available from: URL: https://www.facs. org/covid-19/clinical-guidance/elec¬tive-case/cancer-surgery

COVID-19 Resources. Society of Surgi¬cal Oncology. [cited 2020 Apr 9]. Avail¬able from: URL: https://www.surgonc. org/resources/covid-19-resources/

NCCN covid-19 resources. [cited 2020 Apr 9]. Available from: URL: https:// www.nccn.org/covid-19/theihns.

The Irish Head and Neck Society. theihns. [cited 2020 Apr 9]. Available from: URL: https://theihns.com/covid19

BASO - The British Association of Sur¬gical Oncology: ESSO. [cited 2020 Apr 9]. Available from: URL: https://www. essoweb.org/baso/

Guidelines and Recent Publications. British Gynaecological Cancer Society. [cited 2020 Apr 9]. Available from: URL: https://www.bgcs.org.uk/professionals/ guidelines-for-recent-publications/

Massey PA, McClary K, Zhang AS, Savoie FH, Barton RS. Orthopaedicsur¬gical selection and inpatient paradigms during the coronavirus COVID-19 pan¬demic. J AM Acad Orthop Surg. 2020; 28(11):436-50.

Sahbat Y, Buyuktopcu O, Topkar OM, Erol B. Management of orthopaedicon¬cology patients during coronavirus pan¬demic. J Surg Oncol. 2020; 122:594- 601.

Royal College of Surgeons. Clinical guide to surgical prioritisation during thecoronavirus pandemic. [cited 2020 June 26]. Available from: URL: https:// www.rcseng.ac.uk/coronavirus/surgi¬cal-prioritisation-guidance/..

Stevenson JD, Evans S, Morris G, Till¬man R, Abudu A, Jeys A, et al. Mortality of high- risk orthopaedic oncology pa¬tients during the COVID-19 pandemic: A prospective cohort study. J Surg Oncol. 2020; 10. doi:10.1002/jso.26127.

Chen N, Zhou M, Dong X. Epidemiolog¬ical and clinical characteristics of 99 casesof 2019 novel coronavirus pneu¬monia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507- 13.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adultinpatients with COVID-19 in Wuhan, China: a retro¬spective cohort study. Lancet. 2020; 395(10229):1054-62.

Guo X, Wang J, Hu D. Survery of COVID-19 disease among orthopae¬dicsurgeonsin Wuhan, Peoples republic of China. J Bone Joint Surg Am. 2020; 102:1-854.

Parvizi J, Gehrke T, Krueger CA, Chisari E, CItak M, Van Onsem S, et al. Current concepts review resuming elective or¬thopaedic surgery during COVID-19 pandemic. J Bone Joint Surg Am. 2020; 102(14):1205-1212.

Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19patient needs an operation: operating room prepara¬tion and guidance. Can J Anesth. 2020; 67(6):756-758.