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

Abstract

Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. METHODS: This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. RESULTS: A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (po0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versus 10.3 days, respectively, po0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). CONCLUSION: Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.

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

“…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 .…”

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

“…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).…”

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

“…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.…”