Sanghoon Jheon1, Aneez Db Ahmed2, Vincent Wt Fang3, Woohyun Jung1, Ali Zamir Khan4, Jang-Ming Lee5, Alan Dl Sihoe6, Punnarerk Thongcharoen7, Masahiro Tsuboi8, Akif Turna9, Jun Nakajima10. 1. Department of Cardiothoracic Surgery, Seoul National University Bundang Hospital, Bundang, South Korea. 2. Division of Thoracic Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore. 3. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, China. 4. Department of Minimally Invasive & Robotic Thoracic Surgery, Medanta Hospital, Gurgaon, India. 5. Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei. 6. Gleneagles Hong Kong Hospital, Hong Kong SAR, China. 7. Department of Surgery, Siriraj Hospital, Bangkok, Thailand. 8. Department of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan. 9. Department of Thoracic Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School Istanbul, Turkey. 10. Department of Thoracic Surgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Abstract
OBJECTIVES: Healthcare resources have been mobilized to combat the COVID-19 pandemic of 2020. The Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery reports a consensus statement on the provision of thoracic cancer surgery during this pandemic. METHODS: A Thoracic Experts Panel was convened by the Society. A consensus on the provision, safety, and setting of thoracic cancer surgery during the pandemic was obtained through a Delphi process. RESULTS: Responses were received from 26 panel members (96% response rate) from 10 regions across Asia. The Society recommended that elective thoracic cancer surgery services may need to be reduced or postponed if medical resources were needed for COVID-19 patients, especially intensive care unit beds and ventilators. However, thoracic cancer surgery should proceed as normal for all solid tumors, without restrictions based on disease stage, availability of non-surgical treatment options, or patient condition (unless there is a high likelihood of postoperative intensive care unit stay). Aerosol-forming procedures should be avoided intra- and perioperatively. The surgical approach does not make a difference in terms of safety. Services for thoracic cancer patients should be offered only in hospitals that maintain isolation wards for patients with confirmed or suspected COVID-19. CONCLUSIONS: Services for patients with thoracic cancer should be maintained during the COVID-19 pandemic. The position of the Society is that thoracic surgeons have a responsibility to perform good surgical management of thoracic cancer during the pandemic, to advocate for patients' rights to receive it, and to safeguard patients and staff from infection.
OBJECTIVES: Healthcare resources have been mobilized to combat the COVID-19 pandemic of 2020. The Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery reports a consensus statement on the provision of thoracic cancer surgery during this pandemic. METHODS: A Thoracic Experts Panel was convened by the Society. A consensus on the provision, safety, and setting of thoracic cancer surgery during the pandemic was obtained through a Delphi process. RESULTS: Responses were received from 26 panel members (96% response rate) from 10 regions across Asia. The Society recommended that elective thoracic cancer surgery services may need to be reduced or postponed if medical resources were needed for COVID-19patients, especially intensive care unit beds and ventilators. However, thoracic cancer surgery should proceed as normal for all solid tumors, without restrictions based on disease stage, availability of non-surgical treatment options, or patient condition (unless there is a high likelihood of postoperative intensive care unit stay). Aerosol-forming procedures should be avoided intra- and perioperatively. The surgical approach does not make a difference in terms of safety. Services for thoracic cancerpatients should be offered only in hospitals that maintain isolation wards for patients with confirmed or suspected COVID-19. CONCLUSIONS: Services for patients with thoracic cancer should be maintained during the COVID-19 pandemic. The position of the Society is that thoracic surgeons have a responsibility to perform good surgical management of thoracic cancer during the pandemic, to advocate for patients' rights to receive it, and to safeguard patients and staff from infection.