Impact of the first month of Covid-19 lockdown on oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments - 28/08/20

Doi : 10.1016/j.anorl.2020.06.007

O. Laccourreye ^a,^{^{1
These authors contributed equitably to the study.},}⁎ , H. Mirghani ^a,^{^{1
These authors contributed equitably to the study.}}, D. Evrard ^b,^{^{2
These authors contributed equitably to the study.}}, P. Bonnefont ^c,^{^{2
These authors contributed equitably to the study.}}, L. Brugel ^d, F. Tankere ^c, A. Coste ^d, B. Barry ^b, B. Baujat ^e, S. Atallah ^e,^{^{3
These authors contributed equitably to the study.}}, R. Kania ^f,^{^{3
These authors contributed equitably to the study.}}
^a Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, HEGP, AP–HP, 20-40, rue Leblanc, 75015 Paris, France
^b Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, Hôpital Bichat, AP–HP, 46, rue Henri-Huchard, 75018 Paris, France
^c Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, Hôpital La Pitié-Salpétrière, AP–HP, 47-83; boulevard de l’Hôpital, 75013 Paris, France
^d Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Est, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
^e Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Sorbonne, Hôpital Tenon, AP–HP, 4, rue de la Chine, 75020 Paris, France
^f Service d’ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, AP–HP, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France

^⁎Corresponding author.

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eAbstract

Objective

To evaluate the impact of the first month of lockdown related to the Covid-19 epidemic on the oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments.

Material and methods

A multicenter prospective observational assessment was conducted in 6 university hospital otorhinolaryngology departments (Paris Centre, Nord, Est and Sorbonne) during the 1-month periods before (Month A) and after (Month B) lockdown on March 17, 2020. The main goal was to evaluate lockdown impact on oncologic surgical activity in the departments. Secondary goals were to report population characteristics, surgery conditions, postoperative course, progression of Covid status in patients and surgeons, and adverse events.

Results

224 procedures were performed. There was 10.9% reduction in overall activity, without significant difference between departments. Squamous cell carcinoma and larynx, hypopharynx, oropharynx, oral cavity and nasal cavity and sinus locations were predominant, at 79% and 75.8% of cases respectively, with no significant differences between months. T3/4 and N2/3 tumors were more frequent in Month B (P=.002 and .0004). There was no significant difference between months regarding surgical approach, type of reconstruction, postoperative course, tracheotomy and nasogastric feeding-tube time, intensive care stay or hospital stay. None of the Month A patients were Covid-19-positive, versus 3 in Month B, without adverse events. None of the otorhinolaryngologists involved in the procedures developed symptoms suggesting Covid-19 infestation.

Conclusion

The present study underscored the limited impact of the Covid-19 epidemic and lockdown on surgical diagnosis and cancer surgery in the Ile de France university otorhinolaryngology departments, maintaining chances for optimal survival without spreading the virus.

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Keywords : Covid-19, Cancer, Otorhinolaryngology