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Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients.
Sobrado, Lucas Faraco; Nahas, Caio Sergio Rizkallah; Marques, Carlos Frederico Sparapan; Cotti, Guilherme Cutait de Castro; Imperiale, Antônio Rocco; Averbach, Pedro; Meira Júnior, José Donizeti de; Horvat, Natally; Ribeiro-Júnior, Ulysses; Cecconello, Ivan; Nahas, Sergio Carlos.
  • Sobrado LF; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Nahas CSR; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Marques CFS; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Cotti GCC; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Imperiale AR; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Averbach P; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Meira Júnior JD; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Horvat N; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Ribeiro-Júnior U; Departamento de Radiologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • Cecconello I; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.
  • Nahas SC; Divisao de Cirurgia Gastrointestinal e Colorretal, Departamento de Gastroenterologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo) ; 76: e2507, 2021.
Article in English | MEDLINE | ID: covidwho-1870057
ABSTRACT

OBJECTIVES:

Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic.

METHODS:

This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded.

RESULTS:

A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (p<0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versushttps//doi.org/10.3 days, respectively, p<0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%).

CONCLUSION:

Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Colorectal Surgery / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Language: English Journal: Clinics (Sao Paulo) Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: CLINICS

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Colorectal Surgery / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Language: English Journal: Clinics (Sao Paulo) Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: CLINICS