P31 Thoracic surgery in the COVID-19 era: a tertiary single centre report

Introduction and ObjectivesThe impact of COVID-19 on the UK National Health Service (NHS) has been dramatic Reconfiguration of medical facilities, redeployment of staff and implementation of COVID-19 hospital pathways became daily practice overnight On the 17th of March, additional measures to reduce the nationwide spread of COVID-19 were introduced Elective surgery was largely postponed, maximizing critical care capacity for the predicted number of COVID-19 patients requiring respiratory support The delay to intended curative surgical procedures for early stage lung cancer might result in disease progression and reduced survival We herein evaluated our performance in a thoracic surgery centre during the COVID-19 pandemic in 2020 compared to the equivalent period of time in 2019 MethodsFor this retrospective analysis, data was collected from prospectively populated databases and patients’ medical records during the COVID-19 outbreak in the UK between 16th March to 31st May 2020 and the same period in 2019 ResultsBetween 16th March and 31st May 2019, 220 patients (60% male) underwent thoracic procedures compared to significantly less 145 patients (57% male) in the same period in 2020 [p=0 01] The median age with 67 years (IQR 54, 74;2019) and 63 years (IQR 55, 72;2020, [p=0 24]) was comparable Patients operated in 2020 had higher ASA grades [p<0 0001], however less current smokers underwent operations [p=0 004] 40% of the procedures were lung resections in both years and the rate of pulmonary resections for primary NSCLC was maintained with 25 9% (N=57, 2019) vs 27 6% (N=40, 2020, [p=0 72]) The number of bronchoscopies was intentionally reduced to minimize the risk of SARS-CoV-2 spreading (N=125 in 2019;N=29 in 2020, [p<0 0001]) and no SARS-CoV-2 infection was diagnosed postoperatively No difference in median LOS 5 days (IQR 2, 7 5;2019) versus 4 days (IQR 1, 6 5;2020, [p=0 14]) was detected The mortality remained on the same low level [p=0 49] ConclusionDespite unprecedented pressures and restrictions due to COVID-19, we were able to adapt and run an effective thoracic service With prioritization of urgent cancer procedures, we have shown that we maintained our lung resection rate, whilst ensuring maximal safety for patients and staff