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 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.
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
Medical Education | Medicine and Health Sciences
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students