The Consequences of the COVID-19 Pandemic on Emergency Surgery for Colorectal Cancer

Abstract

The aim of this study is to analyze the impact of the COVID-19 pandemic on the emergency treatment of patients with colorectal cancer in a university surgery clinic. Data from patients undergoing emergency surgery during the pandemic period (2020–2021) was taken into consideration and the results were analyzed and compared with the periods 2016–2017 and 2018–2019. A significant decrease in the number of patients undergoing emergency surgery was reported (p = 0.028). The proportion of patients who presented more severe symptoms at the hospital was significantly higher (p = 0.007). There was an increase in the average duration of surgical interventions compared to pre-pandemic periods (p = 0.021). An increase in the percentage of stomas performed during the pandemic was reported. The average duration of postoperative hospitalization was shorter during the pandemic. A postoperative mortality of 25.7% was highlighted. Conclusions: The pandemic generated by COVID-19 had significant consequences on the emergency treatment of patients with colon cancer. A smaller number of patients showed up at the hospital, and with more severe symptoms. In order to reduce the risk of infection with Sars-CoV-2 virus, the postoperative hospitalization period was shortened and a higher number of protective stomas were performed.

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

“…Most of the included articles were from high-income countries (HICs) (i.e., n = 38, 76.0% from HICs and n = 12, 24.0% from low- and middle-income countries [LMICs]). Seventeen studies reported on the ‘impact of COVID-19’ [ 25 , 27 , 44 , 47 , 48 , 50 – 52 , 57 , 68 – 73 , 75 ], 30 reported on ‘health system responses, effects or challenges’ [ 6 , 7 , 18 , 21 – 24 , 38 , 40 – 43 , 45 , 46 , 49 , 53 – 56 , 58 – 67 , 74 ] and 3 reported on both [ 5 , 26 , 39 ]. We present the key findings below in a narrative synthesis, according to the primary outcomes ( S1 Checklist ).…”

“…Five case-series studies, conducted at an institutional level, compared the number of colorectal cancer procedures performed during the pandemic to that performed during preceding years, pre-COVID-19; one of the studies was from an UMIC (China) and four were from HICs (Italy, Romania, Croatia) [ 39 , 57 , 68 , 70 , 75 ]. The relative percentage reduction in the institutional volume of elective colorectal procedures performed ranged from 11.08%–57.3% across these studies [ 39 , 57 , 68 , 70 , 75 ].…”

“…Eleven of the 18 studies that reported on elective surgery activity were undertaken at an institutional level, which limited their statistical power to show a difference [ 5 , 26 , 39 , 57 , 68 – 73 , 75 ]. Case performance reductions were not caused solely by elective surgery service suspensions; ancillary pandemic- or patient-specific determinants are tabulated ( Table 5 ).…”

Impact of the Covid-19 Pandemic on the Emergency Surgical Treatment of Colorectal Cancer

“…The COVID-19 pandemic required a series of measures from public and private healthcare systems to address the increasing number of infections. These healthcare systems focused mainly on the management of patients infected with the SARS-CoV-2 virus, and as a result, oncological diseases were neglected during the pandemic period 15 .…”

“…CRC management was severely impacted by the pandemic 15 . The screening strategies for this disease were seriously reduced during the pandemic period, with many patients remaining undiagnosed 11 .…”