Abstract:Background and Aims: Despite that the epidemic of novel coronavirus pneumonia (COVID-19) has been under effective control in China, the number of cases outside our country is continuously growing. So, the prevention and control situation is still grim. This study, taking the Department of Breast Surgery in the First Affiliated Hospital of Army Medical University as an example, was designed to analyze and summarize the operations of breast surgery in a comprehensive tertiary hospital during the epidemic, so as to provide effective reference and experiential practice for conducting safe and efficient breast surgery work during epidemic and post-epidemic periods.
Methods: Thirty-seven patients with breast cancer admitted in the Department of Breast Thyroid Surgery of the First Affiliated Hospital of Army Medical University during the COVID-19 epidemic period of January 31, 2020 to February 20, 2020 were selected. The data of the patients including the clinical characteristics, protective measures and treatment effects were retrospectively analyzed. The main points of methods for patients' admission to hospital, preoperative preparation, intraoperative protection and postoperative recovery, as well as the self-protection and psychological counseling of the medical staff were summarized. The effects of specialized treatment and epidemic prevention and control were identified by follow up. The details for how to improve the cognition of potential risk for infectious diseases, and how to strengthen the prevention and control of epidemic disease and occupational protection during the post-epidemic period were analyzed from the aspects of surgical indications, aerosol management and clinic protection in combination with the diagnosis and treatment characteristics of breast surgery.
Results: Thirty-seven patients received surgical treatment after the exclusion of the risk of COVID-19. The mean operative time was (152.23±46.19) min, the average intraoperative blood loss was (85.23±23.47) mL, and no intraoperative blood transfusion was required in any of the patients. Among the 37 breast cancer patients, 19 cases underwent 6 to 8 cycles of preoperative neoadjuvant therapy, of whom, complete pathological remission was obtained in 7 cases after surgery. Prolonged fever occurred in 2 patients after operation, which returned to normal after isolation, body temperature monitoring and symptomatic treatment, and COVID-19 was excluded by nucleic acid testing for SARS?CoV?2. After follow-up, no suspected COVID-19 symptoms such as fever, cough and fatigue were noted in any of the patients or their accompanying relatives, and also no suspected cases were observed among the relevant medical staff.
Conclusion: During the epidemic period, on the premise of scientific prevention and control, and full avoidance of COVID-19 infection in both doctors and patients, aggressive treatment can be provided to breast cancer patients according to the local epidemic situation. The principles of "scientific decision-making, and humanistic service" should be continuously followed, and the various prevention and control guidelines and management norms issued by superiors should be strictly obeyed, and the necessary elements such as prehospital screening, preoperative preparation, intraoperative protection and postoperative recovery of the breast cancer patients should be completed according to the actual situation. Rigorous compliance with the protection measures against epidemic in all aspects of the pre-admission and perioperative period of the patients, and coordinated relations of the epidemic prevention and control with the specialized treatment, may maximally ensure the safe completion of breast surgery and protect the health of the patients and medical personnel.