Evaluating the feasibility of performing elective gastrointestinal cancer surgery during the COVID‐19 pandemic: An observational study with 60 days follow‐up results of a tertiary referral pandemic hospital

Sözütek, Alper; Şeker, Ahmet; Kuvvetli, Adnan; Özer, Nazmi; Genc, Ismail Caner

doi:10.1002/jso.26396

Cited by 16 publications

(24 citation statements)

References 24 publications

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“…That study reported that only non‐PCR‐positive patients were operated on and that none of the patients contracted COVID‐19 during the immediate postoperative period. 16 In contrast to that study, we waited for at least 5 days after admission before surgery and tested each patient for COVID‐19 with PCR and thoracic and abdominal CT scans. The reasoning behind waiting for at least 5 days was to be able to identify patients who had unknowingly contracted COVID‐19 but did not show symptoms, to minimize risk.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of gastrointestinal tumors in a COVID‐19 pandemic hospital: Can open versus minimally invasive surgery be safely performed?

Özdemir

Temiz

2021

Journal of Surgical Oncology

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Purpose In order for patients with gastrointestinal cancer not to suffer the consequences of delayed treatment, they should be operated on in pandemic hospitals under adequate conditions. We aimed to discuss the outcomes of our gastrointestinal cancer surgery patients and to present our patient management recommendations to resume operative treatment during the ongoing COVID‐19 pandemic while taking into account hospital facilities. Materials and Methods This study included 129 gastrointestinal cancer patients who underwent surgery between March 2020 and May 2021 in the gastrointestinal surgery clinic of our hospital, which was assigned as a pandemic hospital in March 2020. Patients' demographic characteristics and preoperative and postoperative findings were recorded. Results Among the patients, 42.6% (n = 55) were female and 57.3% (n = 74) were male. The mean age was 61.89 ± 3.4 years. The primary tumor organs were the stomach 37.2% (n = 48), pancreas 36.4% (n = 47), rectum 11.6% (n = 15), colon 8.5% (n = 11), and esophagus 6.2% (n = 8). The patients were treated with open (75.2%, n = 97) or minimally invasive surgery (24.8%, n = 32; laparoscopic 11.6%, n = 15; robotic 13.2%, n = 17). Eight patients tested positive for COVID‐19 before surgery. No patients developed COVID‐19 during postoperative intensive care or after being moved to the floor unit. There was no COVID‐19‐related morbidity or mortality. Conclusion Failure to treat gastrointestinal cancer patients during the pandemic may result in undesirable consequences, such as stage shift and mortality. Cancer patients can be treated safely with conventional and minimally invasive surgery guided by current recommendations and experience.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of gastrointestinal tumors in a COVID‐19 pandemic hospital: Can open versus minimally invasive surgery be safely performed?

Özdemir

Temiz

2021

Journal of Surgical Oncology

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“…As seen in Sozutek et al, a prospective study of 177 GI cancer patients who underwent elective surgery without delay from March -November 2020, the risk of delaying procedures may be significantly greater than the risk of contracting COVID-19 with proper isolation measures. 14 One limitation of our study is that the decreases seen in a single academic institution may not be generalizable to other sites. However, it is likely that due to the highly multidisciplinary nature of gastrointestinal cancer care, that these trends parallel those observed in similar academic health systems.…”

Section: Resultsmentioning

confidence: 94%

“…As seen in Sozutek et al, a prospective study of 177 GI cancer patients who underwent elective surgery without delay from March ‐ November 2020, the risk of delaying procedures may be significantly greater than the risk of contracting COVID‐19 with proper isolation measures. 14 …”

Section: Discussionmentioning

confidence: 99%

Quantifying the impact of the COVID‐19 pandemic on gastrointestinal cancer care delivery

Perkons¹,

Kim²,

Boedec³

et al. 2021

Cancer Reports

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Background and Aim This study quantifies how changes in healthcare utilization and delivery during the first months of the COVID‐19 pandemic have altered the presentation, treatment, and management of patients with gastrointestinal (GI) malignancies within an academic health system. Methods and results Patients diagnosed with a GI malignancy (ICD10: C15‐C26) who received medical care within the health system during the observation period (first 44 weeks of 2019 and 2020) were identified for a retrospective cohort study. Deidentified patient encounter parameters were collected for this observation period and separated into pre‐pandemic (weeks 1–10) and early pandemic (weeks 11–20) study periods. Difference‐in‐difference analyses adjusted for week‐specific and year‐specific effects quantified the impact of the COVID‐19 pandemic on care delivery between pre‐pandemic and early pandemic study periods in 2020. Across all GI malignancies, the COVID‐19 pandemic has been associated with a significant decline in the number of patients with new patient visits (NPVs) ( p = 1.2 × 10 −4 ), Radiology encounters ( p = 1.9 × 10 −7 ), Surgery encounters ( p = 1.6 × 10 −3 ), Radiation Oncology encounters ( p = 4.1 × 10 −3 ), and infusion visits (6.1 × 10 −5 ). Subgroup analyses revealed cancer‐specific variations in changes to delivery. Patients with colorectal cancer (CRC) had the most significant decrease in NPVs ( p = 7.1 × 10 −5 ), which was significantly associated with a concomitant decrease in colonoscopies performed during the early pandemic period (r 2 = 0.722, p = 2.1 × 10 −10 ). Conclusions The COVID‐19 pandemic has been associated with significant disruptions to care delivery. While these effects were appreciated broadly across GI malignancies, CRC, diagnosed and managed by periodic screening, has been affected most acutely.

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“…Similar outcomes have been reported in patients who underwent surgical procedures for cancer and who have been inpatient with an median length of stay of 10.8 days (SD 6.1; 5 to 37). 21 …”

Section: Discussionmentioning

confidence: 99%

Restoration of elective spine surgery during the first wave of COVID-19

et al. 2021

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Aims With resumption of elective spine surgery services in the UK following the first wave of the COVID-19 pandemic, we conducted a multicentre British Association of Spine Surgeons (BASS) collaborative study to examine the complications and deaths due to COVID-19 at the recovery phase of the pandemic. The aim was to analyze the safety of elective spinal surgery during the pandemic. Methods A prospective observational study was conducted from eight spinal centres for the first month of operating following restoration of elective spine surgery in each individual unit. Primary outcome measure was the 30-day postoperative COVID-19 infection rate. Secondary outcomes analyzed were the 30-day mortality rate, surgical adverse events, medical complications, and length of inpatient stay. Results In all, 257 patients (128 males) with a median age of 54 years (2 to 88) formed the study cohort. The mean number of procedures performed from each unit was 32 (16 to 101), with 118 procedures (46%) done as category three prioritization level. The majority of patients (87%) were low-medium “risk stratification” category and the mean length of hospital stay was 5.2 days. None of the patients were diagnosed with COVID-19 infection, nor was there any mortality related to COVID-19 during the 30-day follow-up period, with 25 patients (10%) having been tested for symptoms. Overall, 32 patients (12%) developed a total of 34 complications, with the majority (19/34) being grade 1 to 2 Clavien-Dindo classification of surgical complications. No patient required postoperative care in an intensive care setting for any unexpected complication. Conclusion This study shows that safe and effective planned spinal surgical services can be restored avoiding viral transmission, with diligent adherence to national guidelines and COVID-19-secure pathways tailored according to the resources of the individual spinal units. Cite this article: Bone Jt Open 2021;2(12):1096–1101.

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Evaluating the feasibility of performing elective gastrointestinal cancer surgery during the COVID‐19 pandemic: An observational study with 60 days follow‐up results of a tertiary referral pandemic hospital

Cited by 16 publications

References 24 publications

Surgical treatment of gastrointestinal tumors in a COVID‐19 pandemic hospital: Can open versus minimally invasive surgery be safely performed?

Surgical treatment of gastrointestinal tumors in a COVID‐19 pandemic hospital: Can open versus minimally invasive surgery be safely performed?

Quantifying the impact of the COVID‐19 pandemic on gastrointestinal cancer care delivery

Restoration of elective spine surgery during the first wave of COVID-19

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