Colorectal surgery during the COVID-19 outbreak: do we need to change?

Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review

“…This reduction or delay is seen in all treatments including surgical treatment [ 15 , 26 , 27 , 29 – 33 , 35 – 37 , 39 – 41 ], chemotherapy [ 26 , 36 , 39 , 42 – 44 ], and long-term radiation therapy [ 26 , 37 ], only cases of emergency surgery [ 38 , 40 ] and short-term radiotherapy [ 26 , 37 ] show an increase. However, in Italy, the number of colorectal resection surgeries [ 34 ] and, in New Zealand, the cases of chemotherapy before and after COVID-19 pandemic have remained unchanged [ 30 ].…”

“…In Italy, despite the similar number of colorectal resection surgeries in 2019 and 2020 (75 in 2019 and 74 in 2020), the percentage of colorectal resection due to cancer has increased (32 cases or 42.6% in 2019 vs. 44 cases or 59.5% in 2020; p = 0.049). Also, the surgery of patients whose tests were positive for COVID-19 was delayed by 15 days until they receive two negative results [ 34 ].…”

The Impact of the Covid-19 Pandemic on Management of Gastrointestinal Malignancies; A Narrative Review

“…The authors advocated for continuation of oncological surgical practices that are evidence based instead of drastically altering treatment patterns, the repercussions of which will be felt only after the passage of a substantial amount of time. 20 These results were echoed in a similar study conducted across a cancer designated hospital in Lombardy Italy which revealed that with adequate preoperative screening using nasopharyngeal swabs and chest CT scans patients could safely undergo elective COVID-19 Pandemic A Narrative Review Pak Armed Forces Med J 2021; 71 (5): 1900 surgical resections with no increased risk of perioperative mortality or virus transmission. 21 Both these studies also negated the hypothesized increased risk of aerosolization with subsequent transmission of the coronavirus due to laparoscopic interventions.…”

“…A retrospective cohort study conducted at a tertiary care referral hospital in Piedmont, Italy a region hardest hit by the coronavirus pandemic assessed the outcomes of CRC surgery conducted during the peak of the pandemic. 20 While overall general surgical procedures saw a decline of 56.3% from 2019, the rate of oncological resection increased from 42.6% in 2019 to 59.5% in 2020 with a comparable post-operative complication rate of 20% in 2019 and 14.9% in 2020. Patients had a median hospital stay of 5 days in both cohorts and no patient or hospital staff acquired COVID-19.…”

“…21 Both these studies also negated the hypothesized increased risk of aerosolization with subsequent transmission of the coronavirus due to laparoscopic interventions. 20,21 In the UK an analogous cancer Hub program was implemented where oncological care was executed uninterrupted in the background of the coronavirus pandemic. A retrospective cohort study conducted at a high volume tertiary trust hospital in Newcastle attempted to compare outcomes of management of esophagogastric cancer before and after the onset of the pandemic.…”