Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era

被引:0
|
作者
Doyle, William N., Jr. [1 ]
Nguyen, Diep [1 ]
West, William J., III [1 ]
Fiedler, Cole R. [1 ]
Labib, Kristie M. [1 ]
Ladehoff, Lauren [1 ]
Carcoana, Allison O. Dumitriu [1 ]
Marek, Jenna C. [1 ]
Malavet, Jose A. [1 ]
Moodie, Carla C. [2 ]
Garrett, Joseph R. [2 ]
Tew, Jenna R. [2 ]
Baldonado, Jobelle J. A. R. [2 ,3 ,4 ]
Fontaine, Jacques P. [2 ,3 ,4 ]
Toloza, Eric M. [2 ,3 ,4 ,5 ]
机构
[1] Univ S Florida, Hlth Morsani Coll Med, Dept Med Educ, Tampa, FL USA
[2] H Lee Moffitt Canc Ctr & Res Inst, Dept Thorac Oncol, Tampa, FL USA
[3] Univ S Florida, Hlth Morsani Coll Med, Dept Surg, Tampa, FL USA
[4] Univ S Florida, Hlth Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
[5] 12902 USF Magnolia Dr, Suite CSB-6 ThorProg, Tampa, FL 33612 USA
来源
关键词
Perioperative; Outcomes; Robotic; Pulmonary; Lobectomy; COVID-19; LUNG-CANCER; IMPACT;
D O I
10.1016/j.sipas.2023.100172
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The COVID-19 pandemic presented patients with barriers to receiving healthcare. We sought to determine whether changes in healthcare access and practice during the pandemic affected perioperative outcomes after robotic-assisted pulmonary lobectomy (RAPL). Methods: We retrospectively analyzed 721 consecutive patients who underwent RAPL. With March 1st, 2020, defining the start of the COVID-19 pandemic, we grouped 638 patients as "PreCOVID-19" and 83 patients as "COVID-19-Era" based on surgical date. Demographics, comorbidities, tumor characteristics, intraoperative complications, morbidity, and mortality were analyzed. Variables were compared utilizing Student's t-test, Wilcoxon rank-sum test, and Chi-square (or Fisher's exact) test, with significance at p & LE; 0.05. Multivariable generalized linear regression was used to investigate predictors of postoperative complication. Results: COVID-19-Era patients had significantly higher preoperative FEV1%, lower cumulative smoking history and higher incidences of preoperative atrial fibrillation, peripheral vascular disease (PVD), and bleeding disorders compared to PreCOVID-19 patients. COVID-19-Era patients had lower intraoperative estimated blood loss (EBL), reduced incidence of new-onset postoperative atrial fibrillation (POAF), but higher incidence of effusion or empyema postoperatively. Overall postoperative complication rates between the groups were similar. Older age, increased EBL, lower preoperative FEV1%, and preoperative COPD are all predictive of an increased risk for postoperative complication. Conclusions: COVID-19-Era patients having lower EBL and less new-onset POAF, despite greater incidences of multiple preoperative comorbidities, demonstrates that RAPL is safe during the COVID-19 era. Risk factors for development of postoperative effusion should be determined to minimize risk of empyema in COVID-19-Era patients. Age, preoperative FEV1%, COPD, and EBL should all be considered when planning for complication risk.
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页数:6
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