INTRODUCTION: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery . Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised . This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery . PATIENTS AND
METHODS: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease . Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020 . The primary endpoint was 30-day COVID-19-related mortality . All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group .
RESULTS: In total , 158 patients were included in the study (71 oesophagectomy , 82 gastrectomy). Overall , 87 patients (57 %) underwent MIS (59 oesophagectomy , 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78 %) completed the health survey . Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres . No patients developed COVID-19 in the post-operative period . Two healthcare workers developed self-limiting COVID-19 .
CONCLUSIONS: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff . Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.