COVID-19 AND COLORECTAL ONCOLOGICAL SURGERY. EXPERIENCE IN A HIGH COMPLEXITY UNIVERSITY HOSPITAL

ABSTRACT

Purpose/Background: Perioperative COVID-19 infection is associated with an increase in morbidity and mortality, in addition to the consequences on surgical pathologies due to delays in diagnosis and treatment. Hypothesis/Aim: The aim of this study it is to describe and evaluate the effects of the pandemic on patients undergoing colorectal cancer surgery in the UC-Christus Healthcare Network. Methods/Interventions: A retrospective observational cross-sectional cohort study was made. It was based on the review of the admissions and surgical protocols of patients operated due to colon and rectal cancer diagnosis between 03/18/2019 - 03/17/2021 in the UC-Christus Healthcare Network. Patients with incomplete records and follow-ups, recurrences, or endoscopic treatments were excluded. The results of patients who were operated before the sanitary restrictions were compared with those who were operated afterwards (03/18/2020). The variables of sex, age, date of surgery, procedure, approach, tumor location, TNM, biopsy, pathological stage, presence of neoadjuvant and/or adjuvant, cause of mortality, emergency admission, and ostomy requirement were recorded in a database. The descriptive and analytic statistics of the results were analyzed using the Microsoft SPSS-Statistics21 program. Proportions were compared with the Chi2 test and Fisher's exact test in variables whose frequency was less than 5. Results/Outcome(s) One hundred seven records were included in the first period (79 colon and 28 rectal tumors) and 134 in the second (100 colon and 34 rectal tumors), with no significant differences between the number of patients nor the distribution by sex in both periods. In the colon tumors group, there were no significant differences between the groups of patients with early-stage (17), locally advanced (118), and metastatic (44) tumors between both periods. Nineteen patients (10.6%) underwent emergency surgery, 36 patients (20.1%) required an ostomy to be performed without significant differences in both periods. At the rectum tumor group, there were no significant differences concerning sex, nor pathological stage, where 17 (26.9%) were in the initial stages, 29 (46%) locally advanced, and 17 (26.9%) were metastatic. The laparoscopic approach was preferred in all tumor groups, requiring conversion in 6 (4.65%) colon tumor and 1 (2.17%) rectal tumor cases. No mortalities were recorded 30, 60, nor 90 days after Limitations: Among the limitations of our study is a selection bias, since it was carried out only in one institution, so the results obtained here are not necessarily extrapolated to the general population. Conclusions/Discussion: In patients operated in the oncology program of the Healthcare Network, there were no significant differences regarding the number of operated patients, their pathological stage, mortality, or approach in the compared periods.