ABSTRACT
Introduction: The standard of care for rectal cancer is total mesorectal resection (TME), but in certain circumstances, there may be a need to perform extended or beyond TME is the norm to ensure negative margins. The pandemic presented a unique challenge of treating patients with cancer while ensuring the safety of patients and health care workers. In this study we share our experience of performing extended TME in the first 6 months of the pandemic. Methods: A retrospective review of prospectively maintained database of the patients who underwent extended or beyond TME surgeries from March and September 2020. Descriptive statistics for patients who had undergone extended resection with curative intent were performed. Results: 16 % of patients who underwent surgery over a 6 month period from March and September, had undergone extended resection. Males accounted for 65 % patients and the mean age was 46 years. 44 patients had surgery for primary rectal cancer. 33 of the 49 patients underwent minimally invasive surgery. 10 patients had major post operative morbidity and there was one death in the immediate post operative period. R0 resection was performed in 95 % of patients. Only 8.2 % of the surgeries performed in the same time period a year before accounted for the extended resections. Conclusion: This study demonstrates the possibility of performing extended resections in advanced colorectal cancer in the times of the covid pandemic while ensuring the safety of the staff and patients without compromising patient outcomes.