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- W3115622721 abstract "Introduction: As cancer surgery restarts following the first COVID-19 wave, healthcare providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19 free surgical pathways were associated with lower postoperative pulmonary complication rates compared to hospitals with no defined pathway. Methods: This international multicentre cohort study included patients undergoing elective surgery for 10 solid cancer types, without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until 19 April 2020. At the time of surgery, hospitals were defined as having a COVID-19 free surgical pathway (complete segregation of the operating theatre, critical care and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with COVID-19 patients). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, ARDS, unexpected ventilation). Results: Of 9171 patients from 447 hospitals in 55 countries, 2481 were operated in COVID-19 free surgical pathways. Patients undergoing surgery within COVID-19 free surgical pathways were younger and less comorbid than those in hospitals with no defined pathway, but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19 free surgical pathways (2.2% versus 4.9%, OR 0.62 [0.44-0.86]). This was consistent in sensitivity analyses and a propensity-score matched model. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19 free surgical pathways (2.1% versus 3.6%; OR 0.53 [0.36-0.76]). Conclusion: Dedicated COVID-19 free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks." @default.
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- W3115622721 date "2021-01-01" @default.
- W3115622721 modified "2023-10-16" @default.
- W3115622721 title "Elective cancer surgery in COVID-19 free surgical pathways during the SARS-CoV-2 pandemic: An international, multi-centre, comparative cohort study" @default.
- W3115622721 doi "https://doi.org/10.1016/j.ejso.2020.11.020" @default.
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