Surgical management of primary liver cancers during the COVID-19 pandemic: overcoming the dilemma with standardization.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
08 2023
Historique:
received: 13 07 2022
revised: 06 04 2023
accepted: 13 04 2023
medline: 31 7 2023
pubmed: 7 5 2023
entrez: 6 5 2023
Statut: ppublish

Résumé

The present study evaluates the impact of the pandemic on outcomes after surgical treatment for primary liver cancer in a high-volume hepatopancreatobiliary surgery center. Patients, who underwent liver resection for primary liver resection between January 2019 and February 2020, comprised pre-pandemic control group. The pandemic period was divided into two timeframes: early pandemic (March 2020-January 2021) and late pandemic (February 2021-December 2021). Liver resections during 2022 were considered as the post-pandemic period. Peri-, and postoperative patient data were gathered from a prospectively maintained database. Two-hundred-eighty-one patients underwent liver resection for primary liver cancer. The number of procedures decreased by 37.1% during early phase of pandemic, but then increased by 66.7% during late phase, which was comparable to post-pandemic phase. Postoperative outcomes were similar between four phases. The duration of hospital stay was longer during the late phase, but not significantly different compared to other groups. Despite an initial reduction in number of surgeries, COVID-19 pandemic had no negative effect on outcomes of surgical treatment for primary liver cancer. The structured standard operating protocol in a high-volume and highly specialized surgical center can withstand negative effects, a pandemic may have on treatment of patients.

Sections du résumé

BACKGROUND
The present study evaluates the impact of the pandemic on outcomes after surgical treatment for primary liver cancer in a high-volume hepatopancreatobiliary surgery center.
METHODS
Patients, who underwent liver resection for primary liver resection between January 2019 and February 2020, comprised pre-pandemic control group. The pandemic period was divided into two timeframes: early pandemic (March 2020-January 2021) and late pandemic (February 2021-December 2021). Liver resections during 2022 were considered as the post-pandemic period. Peri-, and postoperative patient data were gathered from a prospectively maintained database.
RESULTS
Two-hundred-eighty-one patients underwent liver resection for primary liver cancer. The number of procedures decreased by 37.1% during early phase of pandemic, but then increased by 66.7% during late phase, which was comparable to post-pandemic phase. Postoperative outcomes were similar between four phases. The duration of hospital stay was longer during the late phase, but not significantly different compared to other groups.
CONCLUSION
Despite an initial reduction in number of surgeries, COVID-19 pandemic had no negative effect on outcomes of surgical treatment for primary liver cancer. The structured standard operating protocol in a high-volume and highly specialized surgical center can withstand negative effects, a pandemic may have on treatment of patients.

Identifiants

pubmed: 37149487
pii: S1365-182X(23)00124-7
doi: 10.1016/j.hpb.2023.04.007
pmc: PMC10105379
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

907-914

Informations de copyright

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Auteurs

Ali Ramouz (A)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Sanam Fakour (S)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Marzieh Jafari (M)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Elias Khajeh (E)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Mohammad Golriz (M)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany.

Ali Majlesara (A)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Uta Merle (U)

Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany; Department of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany.

Christoph Springfeld (C)

Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany; Department of Medical Oncology, Heidelberg University Hospital, National Center for Tumor Diseases, Heidelberg, Germany.

Thomas Longerich (T)

Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany; Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.

Markus Mieth (M)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany.

Arianeb Mehrabi (A)

Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; Liver Cancer Centre Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany. Electronic address: Arianeb.Mehrabi@med.uni-heidelberg.de.

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Classifications MeSH