Potential impact of COVID-19 on colorectal disease management

Campos, Fábio Guilherme; Fillmann, Henrique Sarubbi

doi:10.1016/j.jcol.2020.06.002

Cited by 4 publications

(10 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Temporizing treatment strategies, such as short-course radiotherapy with prolonged wait to surgery, were used to minimize the effect of delaying CRC resection. 17 Patients with locally advanced rectal cancer who might previously have been considered for pelvic exenteration were deferred because of the resource intensity of this procedure and the expectation that outcomes would be negatively affected in the event of acquiring nosocomial COVID-19 infection during a more prolonged hospital stay. Similarly, patients with metastatic disease may have been offered stenting and systemic anticancer therapy or best supportive care rather than palliative resection of a symptomatic primary tumor.…”

Section: Discussionmentioning

confidence: 99%

“…In the English National Health Service (NHS), one approach to reduce the risk of patients acquiring COVID-19 while in hospital has been the separation of hospitals into “cold” sites used for patients free of COVID-19 and “hot” sites used for all other patients. 17 , 18 Preoperative isolation and COVID-19 swab testing were used in patients having surgery in “cold” and “hot” sites to reduce the risk of community acquired infection. The effectiveness of separating CRC services in this way is uncertain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Treatment and Outcomes of Colorectal Cancer Patients During the COVID-19 Pandemic: A National Population-based Study in England

Kuryba

Boyle

Blake

et al. 2021

Annals of Surgery Open

View full text Add to dashboard Cite

Objective: To compare the management and outcomes of colorectal cancer (CRC) patients during the first 2 months of the COVID-19 pandemic with the preceding 6 months. Background: The pandemic has affected the diagnosis and treatment of CRC patients worldwide. Little is known about the safety of major resection and whether creating “cold” sites (COVID-free hospitals) is effective. Methods: A national study in England used administrative hospital data for 14,930 CRC patients undergoing surgery between October 1, 2019, and May 31, 2020. Mortality of CRC resection was compared before and after March 23, 2020 (“lockdown” start). Results: The number of elective CRC procedures dropped sharply during the pandemic (from average 386 to 214 per week), whereas emergency procedures were hardly affected (from 88 to 84 per week). There was little change in characteristics of surgical patients during the pandemic. Laparoscopic surgery decreased from 62.5% to 35.9% for elective and from 17.7% to 9.7% for emergency resections. Surgical mortality increased slightly (from 0.9% to 1.2%, P = 0.06) after elective and markedly (from 5.6% to 8.9%, P = 0.003) after emergency resections. The observed increase in mortality during the first phase of the pandemic was similar in “cold” and “hot” sites ( P > 0.5 elective and emergency procedures). Conclusions: The pandemic resulted in a 50% reduction in elective CRC procedures during the initial surge and a substantial increase in mortality after emergency resection. There was no evidence that surgery in COVID-free “cold” sites led to better outcomes in the first 2 months.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical Treatment and Outcomes of Colorectal Cancer Patients During the COVID-19 Pandemic: A National Population-based Study in England

Kuryba

Boyle

Blake

et al. 2021

Annals of Surgery Open

View full text Add to dashboard Cite

show abstract

“…The association of COVID-19 infection with elevation resulted in unreliability of the biomarker for surveillance of CRC during the COVID-19 pandemic. Social distancing and lockdown measures made access to colonoscopy difficult during the pandemic, and the use of open access colonoscopy and capsule colonoscopy in surveillance of CRC was encouraged[ 25 , 27 , 33 , 50 , 55 ].…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

“…They also noticed an increase of patients with stage III and stage IV from 22.2% and 19.0% to 26.8% and 26.2%, respectively[ 16 , 62 ]. These changes were attributed to the delays in screening and diagnosis of CRC that was caused by the COVID-19 pandemic[ 17 , 55 , 62 ]. The mode of presentation was also affected by the pandemic as Shinkwin et al [ 59 ] reported an increase in emergency presentation from 28.6% to 36.0%.…”

Section: Clinical Presentation Of Colorectal Cancermentioning

confidence: 99%

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Akbulut¹,

Hargura²,

Garzali³

et al. 2022

WJCC

View full text Add to dashboard Cite

Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis ( ) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.

show abstract

“…Multiprofessional team should have a prior set up plan in order to act urgently with a clear set up strategic therapeutic plan to avoid long term complications of postpending management due to restrictions set due to COVID. 1 Colorectal cancer globally is the second leading cause of cancer deaths, and due to the pandemic adverse outcomes including delay in colorectal follow up clinics, this greatly affected the survival outcomes.…”

Section: Impact Of Covid Pandemic On Colorectal Cancermentioning

confidence: 99%