ABSTRACT
Aim: Colorectal cancer (CRC) is one of the most frequent pathologies worldwide with important complication rates. During the current COVID-19 pandemic, the number and stage of colon tumors have been affected. It's known that COVID+ patients undergoing surgery have a higher rate of complications. However, the existing literature that analyzes the incidence of complications in non-COVID patients with CRC undergoing elective surgery is scarce, thus we perform this review analyzing and presenting our results. Method(s): Retrospective study, we've included patients with colon cancer who underwent scheduled cancer surgery. Groups: Pre-COVID( A): July-2019 to February-2020 and Group-COVID( B): July-2020 to February-2021. Result(s): 172 patients (A:82;B:90) were analyzed, all of them had a negative preoperative PCR-COVID- test. Men:124(72.1%). Age: 72+/-10.1years. LOS: 7(IQR:5-12days). Laparoscopic approach: 142(82.6%). Overall complications: 40.7%. Infectious: 37.2%. SSI: 30.2%. 30-d readmission-rate: 3.5%. Dehiscence: 9.3%. Reintervention: 15.1%. COVID-group presented a greater number of patients with long stay ( > 7days): (62.2% vs. 46.3%;P = 0.03). Use of endoprostheses was higher in the COVID-group (11.1% vs. 2.4%;P = 0.026). In the bivariate analysis, we observed COVID-group presented a higher rate of overall-complications, infectious, SSI, dehiscence and reoperations (51.1% vs. 26.8% P = 0.001;48.9% vs. 24.4% P = 0.001;46.7% vs. 12.2% P = 0.001;15.5% vs. 2.4% P = 0.001;20% vs. 9.7% P = 0.017). No statistically significant differences were found in the 30-d readmission rate (Group A: 2.4%, group B: 4.4% P > 0.05). Conclusion(s): In our environment, during the COVID-19 Pandemic, patients with colon cancer who underwent scheduled cancer surgery, with a negative PCR-COVID test, had higher risk of presenting overall complications and reoperations and, therefore, a longer hospital stay.
ABSTRACT
Aim: The increased burden of care at different points in the healthcare system, due to the COVID 19 pandemic, has led to a delay in diagnosis and treatment in patients with colon cancer, presenting with more advanced disease than patients before the pandemic. The objetive is to test differences in how advanced the disease is in patients with colon cancer, before and during the COVID 19 pandemic. Method(s): Retrospective study in third level hospital, where patients who underwent scheduled surgery for colon cancer were included, dividing them into two groups, pre-Covid group (July 2019-February 2020) and post-Covid group (July 2020-February 2021). We analyzed demographic data, TNM staging, and complications in the immediate postoperative period. Result(s): Data from 172 patients (n = 172), mean age 72 years, 124 males (72.1%) and 48 females (27.9%). We included 82 patients (47.7%) in the pre-Covid group and 90 patients (52.3%) in the post-Covid group. The results obtained were, regarding post-surgical stay, the long stay ( > 7 days) was in preCovid period 46.3% vs postCovid 62.2% (P = 0.037). Regarding TNM staging, those patients with a T >=T4 have been in preCovid period 19.5% vs postCovid 42.2% (P = 0.001), with a stage >=IIa has been preCovid vs postCovid of 70.7% vs 88.9% (P = 0.003), and those with an N > N0 have been preCovid 41.5% vs postCovid 57.8% (P = 0.033). Conclusion(s): The delay in health care, due to the COVID 19 pandemic, has caused in patients operated on for colon cancer a greater progression of the disease in relation to those patients operated on before the pandemic, being striking the greater tumor size as well as the local invasion of the same. Likewise, we have identified an increase in prolonged admissions after surgery.