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Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic
Surgical practice during the coronavirus disease 2019 (COVID-19) pandemic has changed significantly, without supporting data. With increasing experience, a dichotomy of practice is emerging, challenging existing consensus guidelines. One such practice is elective tracheostomy. Here, we share our ini...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834335/ https://www.ncbi.nlm.nih.gov/pubmed/33358522 http://dx.doi.org/10.1016/j.ijom.2020.12.002 |
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author | Batra, T.K. Tilak, M.R. Pai, E. Verma, N. Gupta, B.K. Yadav, G. Dubey, R.K. Francis, N.J. Pandey, M. |
author_facet | Batra, T.K. Tilak, M.R. Pai, E. Verma, N. Gupta, B.K. Yadav, G. Dubey, R.K. Francis, N.J. Pandey, M. |
author_sort | Batra, T.K. |
collection | PubMed |
description | Surgical practice during the coronavirus disease 2019 (COVID-19) pandemic has changed significantly, without supporting data. With increasing experience, a dichotomy of practice is emerging, challenging existing consensus guidelines. One such practice is elective tracheostomy. Here, we share our initial experience of head and neck cancer surgery in a COVID-19 tertiary care centre, emphasizing the evolved protocol of perioperative care when compared to pre-COVID-19 times. This was a prospective study of 21 patients with head and neck cancers undergoing surgery during the COVID-19 pandemic, compared to 193 historical controls. Changes in anaesthesia, surgery, and operating room practices were evaluated. A strict protocol was followed. One patient tested positive for COVID-19 preoperatively. There was a significant increase in pre-induction tracheostomies (28.6% vs 6.7%, P = 0.005), median hospital stay (10 vs 7 days, P = 0.001), and postponements of surgery (57.1% vs 27.5%, P = 0.01), along with a significant decrease in flap reconstructions (33.3% vs 59.6%, P = 0.03). There was no mortality and no difference in postoperative morbidity. No healthcare personnel became symptomatic for COVID-19 during this period. Tracheostomy is safe during the COVID-19 pandemic and rates have increased. Despite increased rescheduling of surgeries and longer hospital stays, definitive cancer care surgery has not been deferred and maximum patient and healthcare worker safety has been ensured. |
format | Online Article Text |
id | pubmed-7834335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78343352021-01-26 Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic Batra, T.K. Tilak, M.R. Pai, E. Verma, N. Gupta, B.K. Yadav, G. Dubey, R.K. Francis, N.J. Pandey, M. Int J Oral Maxillofac Surg Clinical Paper Surgical practice during the coronavirus disease 2019 (COVID-19) pandemic has changed significantly, without supporting data. With increasing experience, a dichotomy of practice is emerging, challenging existing consensus guidelines. One such practice is elective tracheostomy. Here, we share our initial experience of head and neck cancer surgery in a COVID-19 tertiary care centre, emphasizing the evolved protocol of perioperative care when compared to pre-COVID-19 times. This was a prospective study of 21 patients with head and neck cancers undergoing surgery during the COVID-19 pandemic, compared to 193 historical controls. Changes in anaesthesia, surgery, and operating room practices were evaluated. A strict protocol was followed. One patient tested positive for COVID-19 preoperatively. There was a significant increase in pre-induction tracheostomies (28.6% vs 6.7%, P = 0.005), median hospital stay (10 vs 7 days, P = 0.001), and postponements of surgery (57.1% vs 27.5%, P = 0.01), along with a significant decrease in flap reconstructions (33.3% vs 59.6%, P = 0.03). There was no mortality and no difference in postoperative morbidity. No healthcare personnel became symptomatic for COVID-19 during this period. Tracheostomy is safe during the COVID-19 pandemic and rates have increased. Despite increased rescheduling of surgeries and longer hospital stays, definitive cancer care surgery has not been deferred and maximum patient and healthcare worker safety has been ensured. International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. 2021-08 2020-12-11 /pmc/articles/PMC7834335/ /pubmed/33358522 http://dx.doi.org/10.1016/j.ijom.2020.12.002 Text en © 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical Paper Batra, T.K. Tilak, M.R. Pai, E. Verma, N. Gupta, B.K. Yadav, G. Dubey, R.K. Francis, N.J. Pandey, M. Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title | Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title_full | Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title_fullStr | Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title_full_unstemmed | Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title_short | Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic |
title_sort | increased tracheostomy rates in head and neck cancer surgery during the covid-19 pandemic |
topic | Clinical Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834335/ https://www.ncbi.nlm.nih.gov/pubmed/33358522 http://dx.doi.org/10.1016/j.ijom.2020.12.002 |
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