• Elaine Leung, Zahra Pervaiz, Jack Lowe-Zinola, Sian Cree, Audrey Kwong, Natalie Marriott, Florence Cole, Uchechukwu Arum, Barbara Szopinski, Ahmed Elattar, Sudha Sundar, Sean Kehoe, Kavita Singh, Janos Balega, and Jason Yap.
• Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom.
• Gynecol. Oncol. 2021 Mar 1; 160 (3): 649-654.

BackgroundSurgery is the cornerstone of gynecological cancer management, but inpatient treatment may expose both patients and healthcare staff to COVID-19 infections. Plans to mitigate the impact of the COVID-19 pandemic have been implemented widely, but few studies have evaluated the effectiveness of these plans in maintaining safe surgical care delivery.AimTo evaluate the effects of mitigating plans implemented on the delivery of gynecological cancer surgery during the COVID-19 pandemic.MethodsA comparative cohort study of patients treated in a high-volume tertiary gyneoncological centre in the United Kingdom. Prospectively-recorded consecutive operations performed and early peri-operative outcomes during the same calendar periods (January-August) in 2019 and 2020 were compared.ResultsIn total, 585 operations were performed (296 in 2019; 289 in 2020). There was no significant difference in patient demographics. Types of surgery performed were different (p = 0.034), with fewer cytoreductive surgeries for ovarian cancer and laparoscopic procedures (p = 0.002) in 2020. There was no difference in intra-operative complication rates, critical care admission rates or length of stay. One patient had confirmed COVID-19 infection (0.4%). The 30-day post-operative complication rates were significantly higher in 2020 than in 2019 (58 [20.1%] versus 32 [10.8%]; p = 0.002) for both minor and major complications. This increase, primarily from March 2020 onwards, coincided with the first peak of the COVID-19 pandemic in the UK.ConclusionsMaintaining surgical throughput with meticulous and timely planning is feasible during the COVID-19 pandemic but this was associated with an increase in post-operative complications due to a multitude of reasons.Copyright © 2020 Elsevier Inc. All rights reserved.

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