Clinical applicability of the study.
In total, 84% of scheduled surgical procedures were canceled and
therefore will be rescheduled. A significant surplus of volume during
the following months is therefore to be expected, requiring proper
management. Also, we can anticipate that the postponement of these
interventions may lead to spontaneous progression of the disease, and
patients will probably present with more advanced disease stages or more
complicated cases.
Thus, during a subsequent crisis, we should be able to select patients
whose surgical intervention should be postponed at once, while
maintaining significant surgical volume to avoid an excessive wave after
the crisis.
In Paris Area, during April 2020, all the patients requiring ICU could
be adequately treated. Paris Area hospitals were not overwhelmed, even
if the government had at some stage to equip trains to transfer patients
to other regions. It was thus feasible to maintain cancer related
procedures. Most of the ENT cancer procedures can be performed without
the need of a post-operative stay in ICU. The burden of this surgical
activity on ICU beds is thus low in a context of pandemics. To minimize
the loss of chance for the other patients should be a priority while
facing a viral disease spread in the future.