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Head and neck cancer surgery during the coronavirus pandemic: a single-institution experience

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  01 February 2021

J-P Jeannon ,
R Simo ,
R Oakley ,
W Townley ,
G Orfaniotis ,
A Fry ,
A Arora ,
C Taylor  and
I Ahmad
J-P Jeannon*
Affiliation:
Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
R Simo
Affiliation:
Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
R Oakley
Affiliation:
Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
W Townley
Affiliation:
Department of Plastic and Reconstructive Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
G Orfaniotis
Affiliation:
Department of Plastic and Reconstructive Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
A Fry
Affiliation:
Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
A Arora
Affiliation:
Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London, UK
C Taylor
Affiliation:
Department of Anaesthesiology, Guy's and St Thomas’ NHS Foundation Trust, London, UK
I Ahmad
Affiliation:
Department of Anaesthesiology, Guy's and St Thomas’ NHS Foundation Trust, London, UK
*
Author for correspondence: Mr Jean-Pierre Jeannon, Department of Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, LondonSE1 9RT, UK E-mail: jean-pierre.jeannon@gstt.nhs.uk
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Abstract

Objective

The coronavirus disease 2019 pandemic resulted in the cessation of elective surgery. The continued provision of complex head and neck cancer surgery was extremely variable, with some UK centres not performing any cancer surgery. During the pandemic, Guy's and St Thomas’ NHS Foundation Trust received high numbers of coronavirus disease 2019 admissions. This paper presents our experience of elective complex major head and neck cancer surgery throughout the pandemic.

Methods

A head and neck cancer surgery hub was set up that provided a co-ordinated managed care pathway for cancer patients during the pandemic; the Guy's Cancer Centre provided a separate, self-enclosed coronavirus-free environment within the hospital campus.

Results

Sixty-nine head and neck cancer patients were operated on in two months, and 13 patients had a microvascular free tissue transfer. Nosocomial infection with coronavirus disease 2019 was detected in two cases (3 per cent), neither required critical care unit admission. Both patients made a complete recovery and were discharged home. There were no deaths.

Conclusion

Performing major head and neck surgery, including free flap surgery, is possible during the pandemic; however, significant changes to conventional practice are required to achieve desirable patient outcomes.

Keywords

CoronavirusOtolaryngologyPandemics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 2 , February 2021 , pp. 168 - 172
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr J-P Jeannon takes responsibility for the integrity of the content of the paper

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