The Impact of the COVID-19 Pandemic on Gastric Cancer Surgery: A Single-Center Study.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) was declared to be a global pandemic by the World Health Organization on March 11, 2020. The impact on gastric cancer (GC) surgery is unknown. Various reports have shown data indicating that cancer patients with COVID-19 have high morbidity and mortality rates. The choice of surgical procedures and perioperative management of the patients with malignancy has become even more impor¬tant in the COVID-19 pandemic. In this study, we aimed to evaluate the effects of the COVID-19 pandemic on the preopartive, intraoperative, and postoperative findings of patients operated for gastric cancer in our clinic. Materials and Methods: We defined the ‘COVID-19’ period as occurring between 12-03-2020 and 31-08-2020. All the enrolled patients were divided into two groups, pre-COVID-19 group (Pre-CG; 64 cases) and COVID-19 group (CG; 39 cases). A total of 103 patients with gastric cancer were included in this study. Patient characteristics, preoperative, intraoperative, and postoperative clinicopathological findings were compared between groups. Results: The waiting times before admission increased in CG (Pre-CG [6.73±2.85] vs CG [20.61±5.16] ; p<0.001). After admission, the waiting time before surgery was longer in CG (Pre-CG [5.06±3.06] vs CG [6.89±3.32] ; p=0.006). No significant difference was detected between the groups in terms of operation time, surgical procedure, combine organ resection, intraoperative blood transfusion requirment (p values, respectively; p=0.108; p=0.951; p=0.204; p=0.597). Postoperative complications were oesophagojejunostomy leak (3/1) , atelectasis (2/2), duodenal leak (2/2), ileus (3/0), pleural effusion (2/2), and others (1/1), and there was no statistically significant difference between the two groups (p = 0.333). There was no significant difference between the two groups in terms of hospital stay (p = 0.086) and ICU stay (p = 0.989). Conclusion: In this study, it was seen that the COVID-19 pandemic did not affect morbidity and mortality in gastric cancer surgery, but it prolonged admission waiting and operation waiting times. Since there is very little data in the literature regarding the effect of COVID-19 on gastric cancer surgery, our study will guide future studies on this subject. Keywords: COVID-19, Impact, Gastric Cancer, Pandemics, Surgery