P37 COVID-19 and non-emergency cancer operating: Implementing a successful testing system

Early evidence has demonstrated poor peri-operative outcomes for patients undergoing cancer surgery with COVID-19 (C-19) . As a tertiary cancer centre, offering major oesophageal and hepatobiliary surgery we were concerned on how the C-19 pandemic would affect our patients. Elective operating was split between our trust and a local private provider as a “clean” site; and an official trust C-19 screening programme started on 24th April. Methods Retrospectively the electronic theatre record was searched for patients undergoing a non-emergency cancer operation between March & May 2020. The data was cross-referenced with investigations and mortality to ascertain swab results (pre-operatively and 30 days postoperatively) and mortality. Results During the 3 months at the height of the pandemic 596 non-emergency cancer operations took place, (compared with 986 in the same time-frame from 2019). In March 6 of 281, April 98 of 141 and May 166 of 175 patients undergoing an operation had a pre-operative swab, with only 6 screening swabs positive (5 in April, 1 in May). In total 4 patients died, only 1 had a positive C-19 test (patient had not been screened pre-operatively). Conclusion Non-emergency cancer surgery was impacted but Screening was successfully implemented in April and by May 95% of patients underwent testing. Six patients were tested positive post-operatively with only one deceased which appears to show a lower mortality rate than currently quoted within the literature. This adds further evidence that with comprehensive screening, cancer surgery can safely take place during a pandemic.