RESUMO
BACKGROUND: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on postoperative recovery of non-small cell lung cancer (NSCLC) is need to be understood, thereby informing the optimal timing of surgical decision-making during the COVID-19 pandemic for NSCLC patients. This study reports the postoperative outcomes of surgical NSCLC patients with preoperative SARS-CoV-2 infection. METHOD: This single-center retrospective cohort study included 241 NSCLC patients who underwent lobectomy or sub-lobectomy between December 1, 2022 and February 14, 2023. Surgical outcomes of patients with preoperative SARS-CoV-2 infection (stratified by the time from diagnosis of SARS-CoV-2 infection to surgery) were compared with those without preoperative SARS-CoV-2 infection. The primary outcomes were total postoperative complications and postoperative pulmonary complications (PPCs), the secondary outcomes included operation time, total postoperative drainage and time, length of hospital stay (LOS), 30-day and 90-day postoperative symptoms. RESULTS: This study included 153 (63.5%) patients with preoperative SARS-CoV-2 infection and 88 (36.5%) patients without previous SARS-CoV-2 infection. In patients with a preoperative SARS-CoV-2 diagnosis, the incidence of total postoperative complications (OR, 3.00; 95% CI, 1.12-8.01; p = 0.028) and PPCs (OR, 4.20; 95% CI, 1.11-15.91; p = 0.035) both increased in patients infected having surgery within 2 weeks compared with non-infection before surgery. However, patients who underwent lung resection more than 2 weeks after SARS-CoV-2 diagnosis had a similar risk of postoperative complications and surgical outcomes with those non-infection before surgery. CONCLUSION: This is the first study to provide evidence regarding the optimum timing of lung resection surgery and assessing early outcomes after surgery in NSCLC patients with SARS-CoV-2 infection. Our study documents that the SARS-CoV-2 infection did not complicate surgical procedures for lung cancer, and suggest that lung surgery should be postponed at least 2 weeks after SARS-CoV-2 infection for NSCLC patients.
Assuntos
COVID-19 , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumonectomia , Complicações Pós-Operatórias , SARS-CoV-2 , Humanos , COVID-19/complicações , COVID-19/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/virologia , Masculino , Feminino , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/virologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos , Complicações Pós-Operatórias/epidemiologia , Tempo de Internação , Fatores de Tempo , Tempo para o TratamentoRESUMO
The coronavirus disease 2019 was first reported in Wuhan in December 2019 and then spread rapidly throughout the world. On March 11, 2020, the World Health Organization declared coronavirus disease 2019 a pandemic. In response to the pandemic, the management division of West China Hospital oversaw the implementation of hospital-wide emergency measures. In accordance with these measures, the hospital's thoracic surgery ward implemented a new management system by reformulating staff training plans, patient admission procedures, and other systems for managing the ward and protecting perioperative patients. Overall, the ward was successful in restoring normal working order, protecting all staff from occupational exposures, and ensuring the safety of inpatients and their families.