Postoperative outcomes in surgical COVID-19 patients: a multicenter cohort study

Carrier, François Martin; Amzallag, Éva; Lecluyse, Vincent; Côté, Geneviève; Couture, Étienne J.; D’Aragon, Frédérick; Kandelman, Stanislas; Turgeon, Alexis F.; Deschamps, Alain; Nitulescu, Roy; Djade, Codjo Djignefa; Girard, Martin; Beaulieu, Pierre; Richebé, Philippe

doi:10.1186/s12871-021-01233-9

Cited by 36 publications

(48 citation statements)

References 30 publications

(39 reference statements)

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“…In this case, surgery was performed 18 days (within 4 weeks) after the isolation of the patient. According to previous reports, from the viewpoint of safety, surgery is not recommended until at least 4 weeks after the symptoms of COVID-19 resolve [3,5]; however, this "fourweek rule" lacks sufficient evidence because of the small number of cases. Should patients previously infected with COVID-19 have to wait to be operated on for more than 4 weeks?…”

Section: Discussionmentioning

confidence: 99%

“…Although routine evaluation of tolerance for general anesthesia and surgery was performed with blood tests, electrocardiogram, and X-ray, additional venous ultrasound and chest CT scan were needed because of the previous COVID-19 infection. Preoperative screening tests involving venous ultrasound for thrombosis from coagulopathy and chest CT scans for respiratory failure, which are the main causes of postoperative complications in patients infected with COVID-19 [3,5], were important. It was previously reported that pulmonary complications occurred in 18.5%, 11.7%, and 0.0% of patients who were operated on 1-2 weeks, 2-4 weeks, or more than 4 weeks, respectively, after the resolution of COVID-19 symptoms [5].…”

Section: Discussionmentioning

confidence: 99%

“…Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, the recommendation has been to postpone elective laparoscopic colectomy for colon cancer as long as possible because of the need to devote limited equipment and medical staff to the management of COVID-19, the high risk of postoperative complications in patients with colon cancer and COVID-19, and the risk of infecting staff and other patients [1][2][3]. Elective laparoscopic colectomy can be postponed for up to 3 months when colon cancer is in stage III or lower, considering that surgical treatment would be difficult in situations of tumor progression [4].…”

Section: Introductionmentioning

confidence: 99%

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Elective laparoscopic colectomy in a patient 3 weeks after coronavirus disease 2019 infection: a case report

Tateno¹,

Harada²,

Okamoto³

et al. 2021

J Med Case Reports

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Background According to previous reports, surgery is not recommended until at least 4 weeks after the symptoms of coronavirus disease 2019 resolve. However, strong evidence has not been established regarding the optimal timing and preoperative examination for elective laparoscopic colectomy for colorectal cancer in individuals with a previous coronavirus disease 2019 infection. Case presentation A 63-year-old Asian man underwent elective laparoscopic colectomy for sigmoid colon cancer 3 weeks after asymptomatic coronavirus disease 2019. The postoperative course was good, and none of the surgical staff was infected with coronavirus disease 2019. Conclusion In this patient infected with coronavirus disease 2019 within 4 weeks of surgery, preoperative venous ultrasound of the lower extremities and a chest computed tomography scan were useful examinations for ensuring a safe surgical procedure for the patient and the staff. Surgery within 4 weeks may be possible with careful selection of cases based on thorough preoperative examination. This report may contribute to the development of a consensus on performing safe elective colectomy for colon cancer in persons previously infected with coronavirus disease 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Elective laparoscopic colectomy in a patient 3 weeks after coronavirus disease 2019 infection: a case report

Tateno¹,

Harada²,

Okamoto³

et al. 2021

J Med Case Reports

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“…They concluded that co-infection did not result in more complications for emergency abdominal surgery, although an acute abdomen with severe COVID-19 had dismal prognosis. In a multicenter cohort study conducted by Carrier et al [18], they analyzed 44 patients with COVID-19, with 31 surgeries (71%) being urgent. They described that the postoperative 30-day mortality in COVID-19 patients undergoing surgery was high (15.9%).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 patients that needed emergency general surgery: predictors of mortality and postoperative complications

Bozada‐Gutiérrez

Trejo-Ávila

Valenzuela-Salazar

et al. 2021

Preprint

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Purpose There is limited data about the perioperative outcomes of COVID−19 patients that needed emergency general surgery. The aims of the present study were to describe the perioperative outcomes of COVID−19 patients that underwent emergency general surgery and to determine possible predictors of mortality and postoperative complications. Methods A prospective study of positive COVID−19 patients that needed an emergency general surgery procedure at our center was performed. Results From March 2020 to February 2021, 44 patients were included. We found that patients with SARS-CoV−2 symptomatic disease have increased postoperative complications, higher ICU admissions, prolonged length of stay, and decreased 90-day survival as compared with asymptomatic COVID−19 patients. The 90-day survival probability of the entire cohort was 70.1% (60.3–79.9) and was significantly lower in patients with COVID−19 symptoms 63.4% (50.5–76.2). We found the following cut-off values for the prediction of mortality: ferritin ≥ 438.5 ng/mL (AUC = 0.908), CRP value ≥ 12.5 mg/dL (AUC = 0.715), leukocyte ≥ 13.8 x103/µL (AUC = 0.706), and albumin ≤ 2.78 g/dL (AUC = 704,). Also, a cut-off value of CRP of ≥ 12.5 mg/dL yielded an accuracy of 82.9% for the prediction of postoperative complications (p < 0.001). Conclusion Patients with symptomatic COVID−19 that needed emergency surgery have increased postoperative complications, higher ICU admissions, prolonged length of stay, and decreased 90-day survival as compared with asymptomatic COVID−19 patients. Preoperative ferritin, CRP, leukocytes, and albumin could be used as predictors of mortality.

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“…A recent meta-analysis reported a surprising finding, 28 out of 269 patients with COVID-19 infection died from postoperative complications associated with COVID-19, such as respiratory failure and acute respiratory distress syndrome (ARDS)[ 11 ]. A multicenter cohort study in Canada reported that postoperative 30-day mortality in COVID-19 patients was notably high (15.9%)[ 12 ]. To date, several researchers have warned of the increased risk of postoperative mortality in patients with COVID-19 infection and have elucidated the characteristics of high-risk patients[ 9 , 13 - 15 ].…”

Section: General Considerations Regarding Postponement Of Pancreatic Surgerymentioning

confidence: 99%

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

Kato

Asano

Arakawa

et al. 2021

WJCC

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The spread of the new coronavirus (COVID-19) infection in 2020 has had a significant impact on the treatment of cancer worldwide. During the COVID-19 pandemic, the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care. In this review article, from the standpoint of surgeons, we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic, and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors. The most vital points in selecting the best therapeutic approach for patients with pancreatic tumors during this pandemic are (1) Oncologists need to tailor the treatment plan based on the COVID-19 phase, tumor malignant potential, and patients’ comorbidities; and (2) Optimal treatment for pancreatic cancer should be planned according to the condition of each patient and tumor resectability based on national comprehensive cancer network resectability criteria. To choose the best therapeutic approach for patients with pancreatic tumors during this pandemic, we need to tailor the treatment plan based on elective surgery acuity scale (ESAS). Newly established ESAS for pancreatic tumor and flowchart indicating the treatment strategy of pancreatic cancer, are feasible to overcome this situation.

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Postoperative outcomes in surgical COVID-19 patients: a multicenter cohort study

Cited by 36 publications

References 30 publications

Elective laparoscopic colectomy in a patient 3 weeks after coronavirus disease 2019 infection: a case report

Elective laparoscopic colectomy in a patient 3 weeks after coronavirus disease 2019 infection: a case report

Outcomes of COVID-19 patients that needed emergency general surgery: predictors of mortality and postoperative complications

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

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