Background: Short-stay hospitalization of the patient is recognized as a measure of the quality of organization and work of units for surgical treatment of breast cancer, certainly without compromising the quality of treatment. The aim of this paper is to point out the factors that influenced the duration of hospitalization during the Covid 19 pandemic.
Materials and Methods: The duration of hospitalization of 102 patients operated on at the General Surgery Department of the General Hospital Studenica Kraljevo due to breast cancer was examined in the period from 15.03.2020.to 20.06.2021.and for that purpose, the influence of the extent of the operation on the breast-sparing or mastectomy,the extent of the axilla-SLNB or ALND,previous neoadjuvant approach, comorbidity,age,distance of the patient's place of residence (urban or rural area, distant places more than 50 km)was analyzed.The source of data were discharge lists showing the duration of hospitalization in days.
Results: Patients were prepared ambulatory for surgery and operated on time, without a longer preoperative stay. All had a PCR or rapid antigen test for covid 19,which had to be negative.This reduced the possibility of infection with covid 19.Of all 102,there were 44(43%) from rural areas,73(72%) had mastectomy,29(28%) had sparing surgery,negativ SLN had 38(37%),ALND in 56(55%),after neoadjuvant Th were 16(17%) and reoperation was done in 7(7%).One day of hospital stay, discharge on the same day after surgery, had 16%, 75% of them had sparing surgery, 25% mastectomy, 50% SLNB and 25% ALND. The place of residence was very distant for 31% of patients, 20% of them had a pronounced comorbidity.There were 25% under 40 years of age and those older than 80 years 20%. In 20%, neoadjuvant therapy was previously performed.Two days of hospital stay, discharge the day after the operation,had 65%,while 27% of them had sparing surgery, mastectomy 73%, SLNB 36%, ALND 61%, distant with place of residence 45%,3% younger than 40 y and 3% older than 80 y,comorbidity in 10% and neoadjuvant therapy in 12%.Data were analyzed by statistical methods and a statistically significant difference was found that short hospitalizations of only 1 day were more common in smaller operations, less distance from the place of residence,the youngest and oldest patients.There were no complications related to the condition of the operative wound that would be the reason for repeated hospitalization, but in 7 patients (7%) reoperation occurred after a definite PH finding that indicated positive margins or metastases in SLN.
Conclusions: Well-organized breast cancer units and emergency conditions such as the covid 19 pandemic maintain a high level of quality as measured by length of hospitalization, with impact of the decisive factors such as extent of breast and regional lymph node surgery, patient distance, age and comorbidity.
ESSO40-0403