Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era
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 anal...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Surgery in Practice and Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262023000189 |
| _version_ | 1797809762425896960 |
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| author | William N. Doyle, Jr Diep Nguyen William J. West, III Cole R. Fiedler Kristie M. Labib Lauren Ladehoff Allison O. Dumitriu Carcoana Jenna C. Marek Jose A. Malavet Carla C. Moodie Joseph R. Garrett Jenna R. Tew Jobelle J.A.R. Baldonado Jacques P. Fontaine Eric M. Toloza |
| author_facet | William N. Doyle, Jr Diep Nguyen William J. West, III Cole R. Fiedler Kristie M. Labib Lauren Ladehoff Allison O. Dumitriu Carcoana Jenna C. Marek Jose A. Malavet Carla C. Moodie Joseph R. Garrett Jenna R. Tew Jobelle J.A.R. Baldonado Jacques P. Fontaine Eric M. Toloza |
| author_sort | William N. Doyle, Jr |
| collection | DOAJ |
| description | 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≤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. |
| first_indexed | 2024-03-13T06:57:39Z |
| format | Article |
| id | doaj.art-216daf1c7c574705ba628580e0ecc244 |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-13T06:57:39Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-216daf1c7c574705ba628580e0ecc2442023-06-07T04:49:48ZengElsevierSurgery in Practice and Science2666-26202023-06-0113100172Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 EraWilliam N. Doyle, Jr0Diep Nguyen1William J. West, III2Cole R. Fiedler3Kristie M. Labib4Lauren Ladehoff5Allison O. Dumitriu Carcoana6Jenna C. Marek7Jose A. Malavet8Carla C. Moodie9Joseph R. Garrett10Jenna R. Tew11Jobelle J.A.R. Baldonado12Jacques P. Fontaine13Eric M. Toloza14Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USADepartment of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Address Correspondence to: Eric M. Toloza, 12902 USF Magnolia Drive, Suite CSB-6 (ThorProg), Tampa, FL 33612 USA, Telephone: 813-745-7282Background: 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≤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.http://www.sciencedirect.com/science/article/pii/S2666262023000189PerioperativeOutcomesRoboticPulmonaryLobectomyCOVID-19 |
| spellingShingle | William N. Doyle, Jr Diep Nguyen William J. West, III Cole R. Fiedler Kristie M. Labib Lauren Ladehoff Allison O. Dumitriu Carcoana Jenna C. Marek Jose A. Malavet Carla C. Moodie Joseph R. Garrett Jenna R. Tew Jobelle J.A.R. Baldonado Jacques P. Fontaine Eric M. Toloza Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era Surgery in Practice and Science Perioperative Outcomes Robotic Pulmonary Lobectomy COVID-19 |
| title | Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era |
| title_full | Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era |
| title_fullStr | Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era |
| title_full_unstemmed | Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era |
| title_short | Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era |
| title_sort | changes in perioperative outcomes after robotic assisted pulmonary lobectomy during the covid 19 era |
| topic | Perioperative Outcomes Robotic Pulmonary Lobectomy COVID-19 |
| url | http://www.sciencedirect.com/science/article/pii/S2666262023000189 |
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