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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Thoracic surgery outcomes for patients with Coronavirus Disease 2019
Stephanie H Chang1, David Chen1, Darien Paone2
1Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY.
Insights
Thoracic surgery is a viable option for patients hospitalized with Coronavirus Disease 2019 (COVID-19) who develop serious thoracic complications. This study found a 77% survival rate among patients requiring surgery for conditions like pneumothorax, pneumatocele, empyema, or hemothorax.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Pulmonology
Background:
- The Coronavirus Disease 2019 (COVID-19) pandemic presents unique challenges in managing thoracic complications.
- Determining the appropriate role of thoracic surgery in COVID-19 patients is crucial for optimizing outcomes.
Purpose of the Study:
- To evaluate which COVID-19-related thoracic complications necessitate surgical intervention.
- To report the early outcomes of thoracic surgery in hospitalized COVID-19 patients.
Main Methods:
- A single-institution retrospective case series was conducted at New York University Langone Health.
- The study included hospitalized patients with confirmed COVID-19 who underwent thoracic surgery between March 13 and July 18, 2020.
Main Results:
- Out of 1954 COVID-19 admissions, 13 patients (0.7%) required thoracic surgery.
- Surgical indications included complicated pneumothoraces, pneumatocele resection, empyema decortication, and hemothorax management.
- Post-surgery, 69% of patients were discharged, 23% died, and 8% remained hospitalized, with a 77% overall survival rate.
Conclusions:
- Thoracic surgery is a feasible and potentially life-saving intervention for a small subset of COVID-19 patients with severe thoracic complications.
- The findings support the safety of surgical procedures for healthcare providers operating on COVID-19 patients.
Objective:
As the Coronavirus Disease 2019 pandemic continues, appropriate management of thoracic complications from Coronavirus Disease 2019 needs to be determined. Our objective is to evaluate which complications occurring in patients with Coronavirus Disease 2019 require thoracic surgery and to report the early outcomes.
Methods:
This study is a single-institution retrospective case series at New York University Langone Health Manhattan campus evaluating patients with confirmed Coronavirus Disease 2019 infection who were hospitalized and required thoracic surgery from March 13 to July 18, 2020.
Results:
From March 13 to August 8, 2020, 1954 patients were admitted to New York University Langone Health for Coronavirus Disease 2019. Of these patients, 13 (0.7%) required thoracic surgery. Two patients (15%) required surgery for complicated pneumothoraces, 5 patients (38%) underwent pneumatocele resection, 1 patient (8%) had an empyema requiring decortication, and 5 patients (38%) developed a hemothorax that required surgery. Three patients (23%) died after surgery, 9 patients (69%) were discharged, and 1 patient (8%) remains in the hospital. No healthcare providers were positive for Coronavirus Disease 2019 after the surgeries.
Conclusions:
Given the 77% survival, with a majority of patients already discharged from the hospital, thoracic surgery is feasible for the small percent of patients hospitalized with Coronavirus Disease 2019 who underwent surgery for complex pneumothorax, pneumatocele, empyema, or hemothorax. Our experience also supports the safety of surgical intervention for healthcare providers who operate on patients with Coronavirus Disease 2019.
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