Surgery- Scholarly Publications

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Browsing Surgery- Scholarly Publications by Author "Adamina, M"

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    Open Access
    COVID-19-related absence among surgeons: development of an international surgical workforce prediction model
    (2021) Simoes, JFF; Li, E; Glasbey, JC; Omar, OM; Arnaud, AP; Blanco-Colino, R; Burke, J; Chaudhry, D; Cunha, MF; Elhadi, M; Gallo, G; Gujjuri, RR; Kaafarani, HMA; Lederhuber, H; Adamina, M; ...; Ademuyiwa, AO; Agarwal, A; Alameer, E; Alderson, D; et, al
    Background: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. Methods: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). Results: Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7-12, this decreased to 9.2-13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. Conclusion: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.
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    Open Access
    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
    (Wiley, 2020-11) Li, Elizabeth; Glasbey, JC; Nepogodiev, D; Simoes, JFF; Omar, OM; Venn, ML; Evans, JP; Futaba, K; Knowles, CH; Minaya-Bravo, A; Molan, H; Chand, M; Pockney, P; Di Saverio, S; Smart, N; Vallance, A; Vimalachandran, D; Wilkin, RJW; Siaw-Acheampong, K; Benson, RA; Bywater, E; Chaudhry, D; Dawson, BE; Glasbey, JC; ...; Adamina, M; Argawal, A; Akkulak, M; Alameer, E; Alderson, D; Alakoloko, F; et, al
    Aim: This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method: This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results: From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58-14.06), postoperative SARS-CoV-2 (16.90, 7.86-36.38), male sex (2.46, 1.01-5.93), age >70 years (2.87, 1.32-6.20) and advanced cancer stage (3.43, 1.16-10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion: Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks.