By successfully conducting 494 major elective cancer surgeries during COVID pandemic, Tata Memorial sets an example to the world; work published by world’s leading surgical journal.
Health care systems worldwide have been under duress in the ongoing Covid-19 pandemic. As a result, cancer surgeries are being deferred / postponed / cancelled and patients are struggling to access cancer care worldwide with devastating consequences. But amidst the Covid-19 pandemic with Mumbai being the “hotspot”, Tata Memorial Hospital’s Department of Cancer Surgery led by Dr. Shailesh V. Shrikhande, Deputy Director of the Hospital, continued to successfully undertake major elective cancer surgeries with excellent outcomes. This work has now received acclaim in the world’s leading surgical journal “Annals of Surgery” that is published from Harvard, USA. Remarked Dr. Shrikhande, the lead author of this paper, “494 elective surgeries for diverse cancers were performed during a 5-week span starting from the date of national lockdown till end of April. It is important to understand that 64% of these patients were from out of Mumbai and Maharashtra with a sense of despair following a lockdown that was essential in the face of this pandemic. However, thanks to a combination of administrative and scientific rationale we were able to offer curative surgery to all our patients thanks to the service culture of Tata Memorial and the highly specialized teams of surgeons and other support staff. Even more remarkable was the observation that 85% of the operations were major or supra-major and there was no post-operative mortality recorded in these difficult times. The work was not only demanding for surgeons but also for anaesthetists and operating room sisters and ward boys many of whom continued to travel to work with great adversity but they all continue to work till date with a sense of pride and commitment to support the cause of our institution”. The study also noted that while the number of patients over 60 years of age with comorbid conditions like uncontrolled hypertension and diabetes and heart problems were only 64, the rate of complications in these patients were no different compared to the remaining patients younger than 60 years. Despite all standard precautions and testing, 6 patients were detected to be Covid positive in the post-operative period. All of them underwent major surgeries but encouragingly not one required ICU or escalated treatment.
Dr. Rajendra A. Badwe, Director of Tata Memorial Centre remarked “our experience wherein 40-50% of elective cancer surgeries in a “Covid hotspot” were successfully undertaken should be of interest to the scientific community and the general public at large. These results support the continuation of elective major cancer surgery in regions with Covid 19 trends similar to that of India”.
Dr. Shrikhande concluded by stating “Our experience will certainly add to increasing the pool of sparsely available information about the way forward for elective cancer surgeries as the world gradually learns to live with Covid 19 rather than wait to re-start with a pre-Covid era philosophy. The philosophy that regardless of COVID 19, cancer centres and specialists be available to care for their patients, should gain ground as we attempt to navigate through the pandemic. The publication of this report, perhaps documenting the largest published series in the world during the course of this pandemic, will have far reaching positive implications in the making of cancer treatment policy in India and elsewhere in the world”.