To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

This study has shown that intra-operative blood loss was not associated with increased median length of stay nor did it increase the 30 day re-admission rate. However, increased intra-operative blood loss was associated with increased incidence of post-operative morbidity and risk of reoperation within 30 days.

et al. Recommendations for general surgery activities in a pandemic scenario (SARS-CoV-2).

Preoperative tumour localisation is extremely important to correctly identify the site of tumour or lesion at laparoscopy. A standardised departmental protocol should be implemented by all endoscopists to place three spots of tattoo one mucosal fold distal to any significant lesions found. Failure to tattoo lesions/cancers preoperatively can lead to intraoperative delays and potential harm to patients from on-table endoscopy.

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Aim Surgical and oncological outcomes of emergency colorectal cancer (CRC) surgeries are poor compared to those of elective resections. SARS-Cov-2 ambience has added an additional risk on these patients during the course of their perioperative journey. The impact of peri-operative SARS-CoV-2 infection on the outcomes of these unique patients is still under scrutiny. We aimed to analyse a cohort of patients that underwent emergency CRC surgeries during pandemic in our setting. Methods We analysed a prospectively maintained database of all patients who underwent emergency CRC surgeries since 11th of March 2020 to 31st of December 2020. Primary outcome measures were Length of stay (LoS) and 90 day mortality. Secondary outcomes were post-operative complications, SARS-CoV-2 infection rates and 30 day readmission rates. Results We performed a total of 18 emergency CRC surgeries (Male: Female 1:1). Median age was 76.5 years (Range 39-89 years). Median LoS was 13 days (Range 5-110 days). 90 day mortality was 17% (3/18) and of the two patients who died (2/3), their cause of death was COVID-19 related. 4 (22%) patients had peri-operative SARS-CoV-2 infections. 30 day re-admission rate was 16% (3/18). 78% (14/18) of the patients had their cancer resected. 61% (11/18) of the procedures were palliative. Conclusions Peri-operative SARS-CoV-2 infection may have add on effect on the morbidity and mortality on patients undergoing emergency CRC surgeries. Data from large scale multicentre cohort studies would provide more insight in to this.