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https://hdl.handle.net/2440/140253
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Type: | Journal article |
Title: | Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic |
Author: | Bhangu, A. Li, E. Fisher, A. Manku, B. Li, E. Glasbey, J.C. Nepogodiev, D. FF Simoes, J. Omar, O.M. Venn, M.L. Evans, J.P. Futaba, K. Knowles, C.H. Minaya‐Bravo, A. Mohan, H. Chand, M. Pockney, P. Di Saverio, S. Smart, N. Vallance, A. et al. |
Citation: | Colorectal Disease, 2021; 23(3):732-749 |
Publisher: | Wiley |
Issue Date: | 2021 |
ISSN: | 1462-8910 1463-1318 |
Statement of Responsibility: | Elizabeth Li ... Dudi-Venkata N. N., Kroon H. M., Sammour T. ... et al. (COVIDSurg Collaborative) |
Abstract: | Aim: This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method: This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results: From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARSCoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion: Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks. |
Keywords: | COVIDSurg Collaborative Cancer; colon cancer; COVID-19; pandemic; rectal cancer; SARS-CoV-2; surgery; surgical oncology |
Rights: | © 2020 The Association of Coloproctology of Great Britain and Ireland |
DOI: | 10.1111/codi.15431 |
Published version: | http://dx.doi.org/10.1111/codi.15431 |
Appears in Collections: | Surgery publications |
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