Effects of the COVID-19 pandemic on colorectal cancer surgery
Pandemic and colorectal cancer surgery
Keywords:COVID-19, colorectal cancer, effect, pandemic, surgery
Background/Aim: In accordance with the guidelines published during the COVID-19 pandemic, cancer operations, except for emergencies, were postponed. However, the effect of postponed surgical treatment on the outcomes of cancer cases has not yet been determined. Therefore, this study aimed to compare the clinical data and outcomes of patients who underwent surgery for colorectal cancer before and during the pandemic.
Methods: This retrospective cohort study was conducted in the Department of General Surgery. Patients who underwent surgery for colorectal cancer during the pre-pandemic period (February 1, 2019-December 31, 2019) and pandemic period (August 1, 2020-June 30, 2021) were included. The patients’ demographic data, clinical and laboratory findings, clinical presentation, operation type, complications, and pathology results were retrospectively obtained by screening the patient files.
Results: The study included a total of 183 patients, 91 in the pre-pandemic period and 92 in the pandemic period. During the pandemic period, the length of hospital stay was significantly shorter, but the rate of readmission after discharge was significantly higher (P<0.001, P=0.04). There was no significant difference between the two periods in terms of disease stage. During the pandemic period, the number of cases that underwent emergency surgery was significantly higher. The rates of mortality and postoperative complication rates were also significantly higher (P=0.04, P<0.001).
Conclusion: The pandemic had serious effects on colorectal cancer cases. There was an increase in mortality and morbidity due to the increase in complicated cases.
Ren X, Chen B, Hong Y, Liu W, Jiang Q, Yang J, et al. The challenges in colorectal cancer management during COVID-19 epidemic. Annals of Translational Medicine. 2020;8:7. DOI: https://doi.org/10.21037/atm.2020.03.158
Bartlett DL, Howe JR, Chang G, Crago A, Hogg M, Karakousis G, et al. Management of cancer surgery cases during the COVID-19 pandemic: considerations. Annals of Surgical Oncology. 2020;27(6):1717-20. DOI: https://doi.org/10.1245/s10434-020-08461-2
O’Leary MP, Choong KC, Thornblade LW, Fakih MG, Fong Y, Kaiser AM. Management considerations for the surgical treatment of colorectal cancer during the global Covid-19 pandemic. Annals of Surgery. 2020;272(2):e98. DOI: https://doi.org/10.1097/SLA.0000000000004029
Akyol C, Koç MA, Utkan G, Yıldız F, Kuzu MA. The COVID 19 pandemic and colorectal cancer: 5W1H - What should we do to Whom, When, Why, Where and How. Turk J Colorectal Dis. 2020;30(2):67-75. DOI: https://doi.org/10.4274/tjcd.galenos.2020.2020-4-11
Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surgery. 2020;155(8):691-702. DOI: https://doi.org/10.1001/jamasurg.2020.2713
Abate SM, Mantefardo B, Basu B. Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Safety in Surgery. 2020;14(1):1-14. DOI: https://doi.org/10.1186/s13037-020-00262-6
Nachon-Acosta A, Martinez-Mier G, Flores-Gamboa V, Avila-Mercado O, Garcia IM, Yoldi-Aguirre C, et al. Surgical Outcomes During COVID-19 Pandemic. Archives of Medical Research. 2021;52(4):434-42. DOI: https://doi.org/10.1016/j.arcmed.2021.01.003
Fligor SC, Wang S, Allar BG, Tsikis ST, Ore AS, Whitlock AE et al. Gastrointestinal malignancies and the COVID-19 pandemic: evidence-based triage to surgery. Journal of Gastrointestinal Surgery. 2020;24(10):2357-73. DOI: https://doi.org/10.1007/s11605-020-04712-5
Johnson BA, Waddimba AC, Ogola GO, Fleshman Jr JW, Preskitt JTA. Systematic review and meta-analysis of surgery delays and survival in breast, lung and colon cancers: Implication for surgical triage during the COVID-19 pandemic. The American Journal of Surgery. 2021;222(2):311-8. DOI: https://doi.org/10.1016/j.amjsurg.2020.12.015
Maspero M, Mazzola M, Bertoglio CL, Crippa J, Morini L, Magistro C, et al. Major cancer surgery during the coronavirus pandemic: experience from a tertiary referral center and COVID-19 hub in Northern Italy. Journal of British Surgery. 2020;107(10):e440-1. DOI: https://doi.org/10.1002/bjs.11892
Wahed S, Chmelo J, Navidi M, Hayes N, Phillips AW, Immanuel A. Delivering esophago-gastric cancer care during the COVID-19 pandemic in the United Kingdom: a surgical perspective. Diseases of the Esophagus. 2020;33(9):91. DOI: https://doi.org/10.1093/dote/doaa091
Choi JY, Park IJ, Lee HG, Cho E, Kim YI, Kim CW, et al. Impact of the COVID-19 pandemic on surgical treatment patterns for colorectal cancer in a tertiary medical facility in Korea. Cancers. 2021;13(9):2221. DOI: https://doi.org/10.3390/cancers13092221
Shinkwin M, Silva L, Vogel I, Reeves N, Cornish J, Horwood J, et al. COVID‐19 and the emergency presentation of colorectal cancer. Colorectal Disease. 2021;23(8):2014-9. DOI: https://doi.org/10.1111/codi.15662
Cano-Valderrama O, Morales X, Ferrigni CJ, Martín-Antona E, Turrado V, García A, et al. Acute care surgery during the COVID-19 pandemic in Spain: changes in volume, causes and complications. A multicentre retrospective cohort study. International Journal of Surgery. 2020;80:157-61. DOI: https://doi.org/10.1016/j.ijsu.2020.07.002
Mehanathan PB, Edwards AA, Robinson T. Experience of a surgeon at the emergency department during COVID-19 pandemic. Annals of Medicine and Surgery. 2020;60:245-8. DOI: https://doi.org/10.1016/j.amsu.2020.10.047
Filipe M, de Bock E, Geitenbeek R, Boerma D, Pronk A, Heikens J, et al. Impact of the COVID-19 pandemic on surgical colorectal cancer care in The Netherlands: a multicenter retrospective cohort study. Journal of Gastrointestinal Surgery. 2021;25(11):2948-50. DOI: https://doi.org/10.1007/s11605-021-04936-z
Merchant J, Lindsey I, James D, Symons N, Boyce S, Jones O, et al. Maintaining standards in colorectal cancer surgery during the global pandemic: a cohort study. World Journal of Surgery. 2021;45(3):655-61. DOI: https://doi.org/10.1007/s00268-020-05928-x
Xu Y, Huang ZH, Zheng CZL, Li C, Zhang YQ, Guo TA, et al. The impact of COVID-19 pandemic on colorectal cancer patients: a single-center retrospective study. BMC Gastroenterology. 2021;21(1):1-11. DOI: https://doi.org/10.1186/s12876-021-01768-8
Hasirci İ, Ulutas ME, Simsek G, Sahin A, Arslan K, Eryilmaz MA. Evaluation of emergency general surgery operations in COVID-19 patients in a pandemic hospital: a single center experience. International Surgery Journal. 2021:8(8);2267-71. DOI: https://doi.org/10.18203/2349-2902.isj20213118
Intercollegiate General Surgery Guidance on COVID-19; 2020. https://www.rcsed.ac.uk/news-public-affairs/news/2020/march/intercollegiate-general-surgery-guidance-on-covid-19 [accessed 25 March 2020].
Yu GY, Lou Z, Zhang W. Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China. Zhonghua wei chang wai ke za zhi= Chinese Journal of Gastrointestinal Surgery. 2020;23(3):9-11.
Orthopoulos G, Fernandez GL, Dahle JL, Casey E, Jabbour N. Perioperative considerations during emergency general surgery in the era of COVID-19: a US experience. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2020;30(5):481-4. DOI: https://doi.org/10.1089/lap.2020.0266
Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. European Journal of Trauma and Emergency Surgery. 2020;46(3):505-10. DOI: https://doi.org/10.1007/s00068-020-01364-7
Morris SN, Fader AN, Milad MP, Dionisi HJ. Understanding the “scope” of the problem: why laparoscopy is considered safe during the COVID-19 pandemic. Journal of minimally Invasive Gynecology. 2020;27(4):789-91. DOI: https://doi.org/10.1016/j.jmig.2020.04.002
Yeo C, Yeo D, Kaushal S, Ahmed S. Is it too premature to recommend against laparoscopic emergency surgery in COVID-19 patients? Journal of British Surgery. 2020;107(7):e202. DOI: https://doi.org/10.1002/bjs.11668
Ngaserin SHN, Koh FH, Ong BC, Chew MH. COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient. Langenbeck's Archives of Surgery. 2020;405(3):353-5. DOI: https://doi.org/10.1007/s00423-020-01891-2
Brücher BL, Nigri G, Tinelli A, Lapeña JFF, Espin-Basany E, Macri P, et al. COVID-19: Pandemic surgery guidance. 4open. 2020;3:1. DOI: https://doi.org/10.1051/fopen/2020002
ElZanati H, Zohdy M, Samuel S, Marimuthu K. Effect of COVID-19 on stoma formation rates in elective left sided colorectal cancer resections. British Journal of Surgery. 2022;109(5):248. DOI: https://doi.org/10.1093/bjs/znac248.025
Eklöv K, Nygren J, Bringman S, Löfgren J, Sjövall A, Nordenvall C, et al. Trends in treatment of colorectal cancer and short-term outcomes during the first wave of the COVID-19 pandemic in Sweden. JAMA Network Open. 2022;5(5):e2211065. DOI: https://doi.org/10.1001/jamanetworkopen.2022.11065
Morris EJ, Goldacre R, Spata E, Mafham M, Finan PJ, Shelton J, et al. Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. The Lancet Gastroenterology & Hepatology. 2021;6(3):199-208. DOI: https://doi.org/10.1016/S2468-1253(21)00005-4
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