Cancer on Hold, Infections on the Rise: The Unseen Pandemic Effect on Thoracic Surgery in the Developing World

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Infectious Diseases

Background:

• The COVID-19 pandemic significantly impacted global healthcare delivery and surgical case prioritization.
• Tertiary care hospitals experienced shifts in surgical trends, necessitating an analysis of these changes.

Purpose of the Study:

• To compare thoracic surgical trends, including oncologic versus non-oncologic procedures, patient demographics, and outcomes before and during the COVID-19 pandemic.
• To identify specific changes in surgical indications and patient characteristics during the pandemic.

Main Methods:

• A retrospective comparative study of major thoracic surgeries conducted between December 2018 and July 2021.
• Data were divided into pre-pandemic (December 2018-March 2020) and pandemic (April 2020-July 2021) phases.
• Univariate and multivariable analyses were used to compare trends and identify associations.

Main Results:

• Total thoracic surgeries analyzed: 246.
• Oncologic surgeries decreased significantly (41.4% to 21.4%), notably esophagectomy and lung cancer lobectomy.
• Non-oncologic surgeries increased significantly (58.6% to 78.6%), with notable rises in decortication for empyema thoracis and emergency thoracotomy.
• Postoperative complications and mortality rates remained unchanged.

Conclusions:

• The COVID-19 pandemic led to a significant shift in thoracic surgery from oncologic to non-oncologic procedures, particularly infectious and emergency cases.
• The decline in cancer surgeries suggests disruptions in oncologic care pathways.
• Strategies are needed to maintain oncologic care during health crises while addressing emergent thoracic conditions.