Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Sobrado, Lucas Faraco; Nahas, Caio Sergio Rizkallah; Marques, Carlos Frederico Sparapan; Cotti, Guilherme Cutait de Castro; Imperiale, Antonio Rocco; Averbach, Pedro; Júnior, José Donizeti de Meira; Horvat, Natally; Ribeiro, Ulysses; Cecconello, Ivan; Nahas, Sergio Carlos

doi:10.6061/clinics/2021/e2507

Cited by 12 publications

(24 citation statements)

References 13 publications

(14 reference statements)

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“…Urgent patients undergo testing immediately before surgery. Following this protocol allowed safely continuing the surgical treatment of colorectal cancer patients during the pandemic period, as demonstrated in a larger series of our institution 12 .…”

Section: Discussionmentioning

confidence: 82%

Results of Surgical Treatment of Colorectal Cancer, Elective and Emergency, in Patients With Covid-19

Nahas

Júnior

Nahas

et al. 2022

ABCD, arq. bras. cir. dig.

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Section: Discussionmentioning

confidence: 82%

Results of Surgical Treatment of Colorectal Cancer, Elective and Emergency, in Patients With Covid-19

Nahas

Júnior

Nahas

et al. 2022

ABCD, arq. bras. cir. dig.

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“…The detailed characteristics of the included studies are shown in Table 1 . There were 16 case report [ 16 , 32 , 46 , 48 – 50 , 52 , 54 , 55 , 59 , 66 , 67 , 71 , 75 , 82 , 84 ], 9 case series, 41 cohort [ 8 – 17 , 23 , 25 , 26 , 29 , 31 , 34 , 43 – 45 , 51 , 53 , 56 – 58 , 60 – 65 , 68 – 70 , 73 , 74 , 77 , 79 , 80 , 83 , 85 ], 2 cross-sectional [ 72 , 76 ] and 1 case–control [ 81 ] studies. These studies were conducted in China ( n = 15), Italy ( n = 8), United States ( n = 6), United Kingdom ( n = 6), Spain ( n = 5), India ( n = 4), France ( n = 3), Turkey ( n = 2), Brazil ( n = 2), Japan ( n = 2), Colombia ( n = 1), Philippines ( n = 1), Poland ( n = 1), Iran ( n = 1), The Netherlands ( n = 1), Belgium ( n = 1), United Arab Emirates ( n = 1), Mexico ( n = 1), Sweden ( n = 1), Austria ( n = 1), Hungary ( n = 1), Australia ( n = 1), and Chile ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

Colorectal cancer in patients with SARS-CoV-2: a systematic review and meta-analysis

Alhumaid

Mutair

Busubaih

et al. 2022

Infect Agents Cancer

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Background Patients with colorectal cancer (CRC) are more likely to develop severe course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and experience increased risk of mortality compared to SARS-CoV-2 patients without CRC. Objectives To estimate the prevalence of SARS-CoV-2 infection in CRC patients and analyse the demographic parameters, clinical characteristics and treatment outcomes in CRC patients with COVID-19 illness. Methods For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature for studies on the incidence of SARS-CoV-2 infection in CRC patients, published from December 1, 2019 to December 31, 2021, with English language restriction. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). Sub-group analyses were performed to minimize heterogeneity. Binary logistic regression model was used to explore the effect of various demographic and clinical characteristics on patient’s final treatment outcome (survival or death). Results Of the 472 papers that were identified, 69 articles were included in the systematic review and meta-analysis (41 cohort, 16 case-report, 9 case-series, 2 cross-sectional, and 1 case-control studies). Studies involving 3362 CRC patients with confirmed SARS-CoV-2 (all patients were adults) were analyzed. The overall pooled proportions of CRC patients who had laboratory-confirmed community-acquired and hospital-acquired SARS-CoV-2 infections were 8.1% (95% CI 6.1 to 10.1, n = 1308, 24 studies, I2 98%, p = 0.66), and 1.5% (95% CI 1.1 to 1.9, n = 472, 27 studies, I2 94%, p < 0.01). The median patient age ranged from 51.6 years to 80 years across studies. The majority of the patients were male (n = 2243, 66.7%) and belonged to White (Caucasian) (n = 262, 7.8%), Hispanic (n = 156, 4.6%) and Asian (n = 153, 4.4%) ethnicity. The main source of SARS-CoV-2 infection in CRC patients was community-acquired (n = 2882, 85.7%; p = 0.014). Most of those SARS-CoV-2 patients had stage III CRC (n = 725, 21.6%; p = 0.036) and were treated mainly with surgical resections (n = 304, 9%) and chemotherapies (n = 187, 5.6%), p = 0.008. The odd ratios of death were significantly high in patients with old age (≥ 60 years) (OR 1.96, 95% CI 0.94–0.96; p < 0.001), male gender (OR 1.44, 95% CI 0.41–0.47; p < 0.001) CRC stage III (OR 1.54, 95% CI 0.02–1.05; p = 0.041), CRC stage IV (OR 1.69, 95% CI 0.17–1.2; p = 0.009), recent active treatment with chemotherapies (OR 1.35, 95% CI 0.5–0.66; p = 0.023) or surgical resections (OR 1.4, 95% CI 0.8–0.73; p = 0.016) and admission to ICU (OR 1.88, 95% CI 0.85–1.12; p < 0.001) compared to those who survived. Conclusion SARS-CoV-2 infection in CRC patient is not uncommon and results in a mortality rate of 26.2%. Key determinants that lead to increased mortality in CRC patients infected with COVID-19 include older age (≥ 60 years old); male gender; Asian and Hispanic ethnicity; if SARS-CoV-2 was acquired from hospital source; advanced CRC (stage III and IV); if patient received chemotherapies or surgical treatment; and if patient was admitted to ICU, ventilated or experienced ARDS.

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“…Additionally, the tumoral features of the cases were also analyzed in this study. A similar methodology was used in a study by Sobrado et al [ 21 ], in which they evaluated the elective colorectal surgical procedures used during the COVID-19 pandemic. In said study, the malignant cases comprised the majority (90.9%) of cases.…”

Section: Discussionmentioning

confidence: 99%

The effect of the COVID-19 pandemic on the outcomes of surgically treated colorectal diseases: a retrospective cohort study

Okuyan

Yıldırım

2022

Ann Surg Treat Res

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Purpose The objective of this study is to evaluate the effect of the coronavirus disease 2019 (COVID-19) pandemic on elective and emergent colorectal surgical practice. Methods The population of this retrospective observational study consisted of all consecutive patients who underwent emergent or elective colorectal surgery between March 2019 and March 2021. The patients were divided into 2 groups: the prepandemic group who were treated between March 2019 and March 10, 2020, and the pandemic group who were treated between March 11, 2020 and March 2021. The rate of emergent operations was the primary outcome. The groups were compared based on the frequency of operations, distribution of tumoral features in malignant cases, and 90th-day mortality rates. Results There were 180 and 121 patients in the prepandemic and pandemic groups, respectively. There were significantly more patients of the American Society of Anesthesiologists physical status stage IV with comorbidity in the pandemic group than in the prepandemic group (P = 0.016 and P < 0.001, respectively). The rate of emergent operations was significantly higher in the pandemic group than in the prepandemic group (49.6% vs. 26.7%, P < 0.001). There were significantly more patients who received non-resectional surgery in the pandemic group than in the prepandemic group (P = 0.002). Additionally, there were significantly more patients without resection among patients with a defunctioning stoma (P = 0.001). The length of hospital stay (LoS) was significantly shorter in the pandemic group than in the prepandemic group (P = 0.039). On the other hand, the mortality rate was significantly higher in the pandemic group than in the prepandemic group (15.7% vs. 6.1%, P = 0.011). Conclusion The study findings suggested that the COVID-19 pandemic adversely affected colorectal surgical practices, resulting in more frequent emergent operations, non-resectional procedures with stoma formation, and higher mortality rates.

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Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Cited by 12 publications

References 13 publications

Results of Surgical Treatment of Colorectal Cancer, Elective and Emergency, in Patients With Covid-19

Results of Surgical Treatment of Colorectal Cancer, Elective and Emergency, in Patients With Covid-19

Colorectal cancer in patients with SARS-CoV-2: a systematic review and meta-analysis

The effect of the COVID-19 pandemic on the outcomes of surgically treated colorectal diseases: a retrospective cohort study

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