Practice Patterns of Colorectal Surgery During the COVID-19 Pandemic

Wu, Xianrui; Zhang, Yunfeng; Lan, Nan; Zhang, Zhong-Tao; Wang, Xishan; Shen, Bo; Lan, Ping; Kiran, Ravi P.

doi:10.1097/dcr.0000000000001840

Cited by 7 publications

(6 citation statements)

References 13 publications

(10 reference statements)

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“…Although number of cases were small, rates of colectomy were comparable among individuals treated as inpatients and the two cohorts managed as outpatients. Results from these studies suggest that healthcare providers should continue to adapt hospital-based treatment pathways to improve care of patients with newly diagnosed IBD while limiting their risk of SARS-CoV-2 infection 95…”

Section: Impact Of Covid-19 On Ibdmentioning

confidence: 99%

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Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Lin

Lau

Chanchlani

et al. 2022

Gut

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The COVID-19 pandemic has raised considerable concerns that patients with inflammatory bowel disease (IBD), particularly those treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 acquisition, develop worse outcomes following COVID-19, and have suboptimal vaccine response compared with the general population. In this review, we summarise data on the risk of COVID-19 and associated outcomes, and latest guidance on SARS-CoV-2 vaccines in patients with IBD. Emerging evidence suggests that commonly used medications for IBD, such as corticosteroids but not biologicals, were associated with adverse outcomes to COVID-19. There has been no increased risk of de novo, or delayed, IBD diagnoses, however, an overall decrease in endoscopy procedures has led to a rise in the number of missed endoscopic-detected cancers during the pandemic. The impact of IBD medication on vaccine response has been a research priority recently. Data suggest that patients with IBD treated with antitumour necrosis factor (TNF) medications had attenuated humoral responses to SARS-CoV-2 vaccines, and more rapid antibody decay, compared with non-anti-TNF-treated patients. Reassuringly, rates of breakthrough infections and hospitalisations in all patients who received vaccines, irrespective of IBD treatment, remained low. International guidelines recommend that all patients with IBD treated with immunosuppressive therapies should receive, at any point during their treatment cycle, three primary doses of SARS-CoV-2 vaccines with a further booster dose as soon as possible. Future research should focus on our understanding of the rate of antibody decay in biological-treated patients, which patients require additional doses of SARS-CoV-2 vaccine, the long-term risks of COVID-19 on IBD disease course and activity, and the potential risk of long COVID-19 in patients with IBD.

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Section: Impact Of Covid-19 On Ibdmentioning

confidence: 99%

“…Results from these studies suggest that healthcare providers should continue to adapt hospital-based treatment pathways to improve care of patients with newly diagnosed IBD while limiting their risk of SARS-CoV-2 infection. 95 …”

Section: Impact Of Covid-19 On Ibdmentioning

confidence: 99%

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Lin

Lau

Chanchlani

et al. 2022

Gut

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Section: Discussionmentioning

confidence: 99%

“…Early experience from China suggested that the COVID-19 pandemic clearly influenced the care of patients with colorectal diseases; elective surgeries were especially more affected than emergency surgeries [ 7 ]. Utilizing our newly designed list prioritization and careful patient selection, we were able to increase our colorectal resection numbers to almost double when compared to the same time frame a year ago.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Colorectal Cancer Surgery Services During COVID-19 First Wave With Pre-COVID Time

Rashid¹,

Raza²,

Thomas³

et al. 2021

Cureus

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The first confirmed case of COVID-19 in the United Kingdom (UK) was reported on 29 January 2020. The country saw the peak of infection between March and May of 2020. The result was a change in the practice of how we treat most surgical conditions including cancer. We continued providing service to our colorectal cancer patients at a District General Hospital. The aim of this study was to compare our provision of colorectal cancer service during the peak of the pandemic to that of the pre-COVID time in our hospital. MethodsWe collected data of all colorectal cancer patients who underwent surgery between 1 March 2020 and 30 April 2020 in our hospital. The comparative data were collected for similar patients during the same time frame in 2019. A detailed data set was compiled on Microsoft Excel (Microsoft Corp, Washington) and analysed using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012. IBM Corp, Armonk, NY). ResultsThe two groups were comparable in demographics including age, BMI, gender, and Charlson comorbidity index. Time from decision-to-treat to surgery, post-operative HDU/ITU stay, and overall length of stay was shorter in the COVID group than the Pre-COVID group without any significant statistical difference. There was no statistically significant difference between the two groups in Calvien-Dindo complications grade 1 and 2. No mortality was reported due to direct or indirect consequences of COVID-19 infection. More open procedures were performed in our department during the first wave of COVID-19 in the UK compared to Pre-COVID time. ConclusionsDespite the challenges we faced during the peak of the COVID-19 pandemic, we managed to provide standard care to our colorectal cancer patients with comparable post-operative surgical and oncological outcomes.

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“…Early experience from China suggested that the COVID-19 pandemic clearly influenced the care of patients with cancer surgeries were especially more affected than emergency surgeries [6].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Lymph Node Involvement in Carcinomas during Precovid and Covid Era

Manasvi

Gowtham

2021

JPRI

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Background: This is a clinicopathological study comparing the involvement of lymph nodes in various carcinomas before and during the COVID-19 period. During the pandemic the access to healthcare and timely detection and intervention of carcinomas were severely affected. This delay in treatment has led to the progression of malignancies and metastasis to lymph nodes. Methods: A retrospective study was conducted of 40 patients (20 from 2019 and 20 from 2021) with carcinomas who were treated by surgical excision of tumour combined with lymph node resection. Histopathological examination of the nodes was done to detect malignant metastasis and the average node positivity rate was calculated. Results: Lymph node metastasis was observed in 10 patients in 2019 (50%) and 16 patients in 2021 (80%). The average node positivity rate is significantly higher in 2021 than in 2019, in 2019 it is 31% and in 2021 it is 43%. Lymph node metastasis is expected to increase by 43% in 2021. Conclusion: In the Covid-19 pandemic, a significant decrease and delay of patients presenting to the OPD for neoplasms, resulting in a delay in the diagnosis and treatment of advanced-stage neoplasms that manifest as metastases in the regional lymph nodes. Surgeons need to be vigilant and extensively explore the all draining affected lymph nodes and resect them.

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Practice Patterns of Colorectal Surgery During the COVID-19 Pandemic

Cited by 7 publications

References 13 publications

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Comparison of Colorectal Cancer Surgery Services During COVID-19 First Wave With Pre-COVID Time

Comparison of Lymph Node Involvement in Carcinomas during Precovid and Covid Era

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