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

Authors

William Nick Doyle BS, Lehigh Valley Health NetworkFollow
Diep Nguyen
William J West
Cole R Fiedler
Kristie M Labib
Lauern Ladehoff, Lehigh Valley Health NetworkFollow
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

Publication/Presentation Date

6-1-2023

Abstract

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 1

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.

Volume

13

First Page

100172

Last Page

100172

ISSN

2666-2620

Published In/Presented At

Doyle, W. N., Jr, Nguyen, D., West, W. J., 3rd, Fiedler, C. R., Labib, K. M., Ladehoff, L., Dumitriu Carcoana, A. O., Marek, J. C., Malavet, J. A., Moodie, C. C., Garrett, J. R., Tew, J. R., Baldonado, J. J. A. R., Fontaine, J. P., & Toloza, E. M. (2023). Changes in Perioperative Outcomes after Robotic-Assisted Pulmonary Lobectomy during the COVID-19 Era. Surgery in practice and science, 13, 100172. https://doi.org/10.1016/j.sipas.2023.100172

Disciplines

Medical Education | Medicine and Health Sciences

PubMedID

37139165

Department(s)

USF-LVHN SELECT Program, USF-LVHN SELECT Program Students

Document Type

Article