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

Özdemir, Yılmaz; Temiz, Ayetullah

doi:10.1002/jso.26653

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…Most of the included articles were from high-income countries (HICs) (i.e., n = 38, 76.0% from HICs and n = 12, 24.0% from low- and middle-income countries [LMICs]). Seventeen studies reported on the ‘impact of COVID-19’ [ 25 , 27 , 44 , 47 , 48 , 50 – 52 , 57 , 68 – 73 , 75 ], 30 reported on ‘health system responses, effects or challenges’ [ 6 , 7 , 18 , 21 – 24 , 38 , 40 – 43 , 45 , 46 , 49 , 53 – 56 , 58 – 67 , 74 ] and 3 reported on both [ 5 , 26 , 39 ]. We present the key findings below in a narrative synthesis, according to the primary outcomes ( S1 Checklist ).…”

Section: Resultsmentioning

confidence: 99%

“…Nine of 23 articles on health system responses pertained to breast cancer; 8 to colorectal cancer and 6 to breast- and colorectal cancer [ 5 – 7 , 18 , 21 – 24 , 26 , 38 – 42 , 43 , 45 , 46 , 49 , 53 – 56 , 74 ]. Key themes are presented narratively with reference to the Structures-Processes-Outcomes model by Donabedian (1966) [ 36 ] ( Fig 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

Haribhai

Bhatia

Shahmanesh

2023

PLOS Glob Public Health

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Globally, 28.4 million non-emergent (‘elective’) surgical procedures have been deferred during the COVID-19 pandemic. This study evaluated the impact of the COVID-19 pandemic on elective breast- or colorectal cancer (CRC) procedure backlogs and attributable mortality, globally. Further, we evaluated the interaction between procedure deferrals and health systems, internationally. Relevant articles from any country, published between December 2019–24 November 2022, were identified through searches of online databases (MEDLINE, EMBASE) and by examining the reference lists of retrieved articles. We organised health system-related findings thematically per the Structures-Processes-Outcomes conceptual model by Donabedian (1966). Of 337 identified articles, we included 50. Eleven (22.0%) were reviews. The majority of included studies originated from high-income countries (n = 38, 76.0%). An ecological, modelling study elucidated that global 12-week procedure cancellation rates ranged from 68.3%–73%; Europe and Central Asia accounted for the majority of cancellations (n = 8,430,348) and sub-Saharan Africa contributed the least (n = 520,459). The percentage reduction in global, institutional elective breast cancer surgery activity ranged from 5.68%–16.5%. For CRC, this ranged from 0%–70.9%. Significant evidence is presented on how insufficient pandemic preparedness necessitated procedure deferrals, internationally. We also outlined ancillary determinants of delayed surgery (e.g., patient-specific factors). The following global health system response themes are presented: Structural changes (i.e., hospital re-organisation), Process-related changes (i.e., adapted healthcare provision) and the utilisation of Outcomes (i.e., SARS-CoV-2 infection incidence among patients or healthcare personnel, postoperative pulmonary complication incidence, hospital readmission, length of hospital stay and tumour staging) as indicators of health system response efficacy. Evidence on procedure backlogs and attributable mortality was limited, partly due to insufficient, real-time surveillance of cancer outcomes, internationally. Elective surgery activity has decreased and cancer services have adapted rapidly, worldwide. Further research is needed to understand the impact of COVID-19 on cancer mortality and the efficacy of health system mitigation measures, globally.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

Haribhai

Bhatia

Shahmanesh

2023

PLOS Glob Public Health

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“…If postoperative patients develop symptoms suggestive of COVID-19, a polymerase chain reaction test should be performed. In particular, Prasad et al report that female patients with end-stage renal disease, congestive heart failure, COPD, liver cirrhosis, cancer, or undergoing neurosurgical procedures are more likely to test positive for SARS CoV-2 after elective surgery [ 44 , 45 ]. It could also be useful to manage the periodic remote follow-up.…”

Section: Resultsmentioning

confidence: 99%

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Cortegiani

Tripodi

Castioni

et al. 2022

J Anesth Analg Crit Care

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Background The appropriate timing of surgery and perioperative management of patients with previous SARS-CoV-2 infection are open issues. The purpose of this document is to support the clinical decision-making process regarding the patient with previous Sars-CoV-2 infection to undergo elective surgery. The recipients of this document are physicians, nurses, healthcare personnel, and other professionals involved in the patient’s surgical process. Methods The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) selected 11 experts to reach a consensus on key aspects of this theme in adult and pediatric population. The methods of this process document were in accordance to the principles of rapid review of the scientific literature and modified Delphi method. The experts produced statements and supporting reasons in the form of an informative text. The overall list of statements was subjected to a vote in order to express the degree of consent. Results Patients should not undergo elective surgery within 7 weeks of infection unless there is the risk of a negative evolution of the disease. To mitigate the risk of postsurgical mortality, a multidisciplinary approach seemed useful in addition to the use of validated algorithms to estimate the risk of perioperative morbidity and mortality; the risk related to SARS-CoV-2 infection should be added. The risk of potential nosocomial contagion from a positive patients should also be considered when deciding to proceed with surgery. Most of the evidence came from previous SARS-CoV-2 variants, so the evidence should be considered indirect. Conclusion A balanced preoperative multidisciplinary risk–benefit evaluation is needed in patients with previous infection by SARS-CoV-2 for elective surgery.

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“…Fifteen articles reporting on the practice of RAS during the COVID-19 pandemic were suitable for inclusion ( Table 1 ), reporting on data from 5193 patients [ 6 , 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 23 , 24 ]. This included seven prospective cohort studies (PCS), three cross-sectional cohort studies (CCS), three retrospective comparative cohort studies (RCCS), and two retrospective cohort studies (RCS).…”

Section: Resultsmentioning

confidence: 99%

“…Despite these early concerns regarding RAS in the setting of the COVID-19 pandemic, the evidence did not identify inferior clinical outcomes related to RAS practice during the pandemic [ 7 , 16 , 19 , 21 , 23 ]. In fact, some benefits associated with utilisation of a robotic-assisted approach to surgery during the pandemic were identified.…”

Section: Discussionmentioning

confidence: 99%

Robotic Abdominal Surgery and COVID-19: A Systematic Review of Published Literature and Peer-Reviewed Guidelines during the SARS-CoV-2 Pandemic

Fleming

Fullard

Croghan

et al. 2022

JCM

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Background: Significant concern emerged at the beginning of the SARS-CoV-2 pandemic regarding the safety and practicality of robotic-assisted surgery (RAS). We aimed to review reported surgical practice and peer-reviewed published review recommendations and guidelines relating to RAS during the pandemic. Methods: A systematic review was performed in keeping with PRISMA guidelines. This study was registered on Open Science Framework. Databases were searched using the following search terms: ‘robotic surgery’, ‘robotics’, ‘COVID-19’, and ‘SARS-CoV-2’. Firstly, articles describing any outcome from or reference to robotic surgery during the COVID-19/SARS-CoV-2 pandemic were considered for inclusion. Guidelines or review articles that outlined recommendations were included if published in a peer-reviewed journal and incorporating direct reference to RAS practice during the pandemic. The ROBINS-I (Risk of Bias in Non-Randomised Studies of Intervention) tool was used to assess the quality of surgical practice articles and guidelines and recommendation publications were assessed using the AGREE-II reporting tool. Publication trends, median time from submission to acceptance were reported along with clinical outcomes and practice recommendations. Results: Twenty-nine articles were included: 15 reporting RAS practice and 14 comprising peer-reviewed guidelines or review recommendations related to RAS during the pandemic, with multiple specialities (i.e., urology, colorectal, digestive surgery, and general minimally invasive surgery) covered. Included articles were published April 2020—December 2021, and the median interval from first submission to acceptance was 92 days. All surgical practice studies scored ‘low’ or ‘moderate’ risk of bias on the ROBINS-I assessment. All guidelines and recommendations scored ‘moderately well’ on the AGREE-II assessment; however, all underperformed in the domain of public and patient involvement. Overall, there were no increases in perioperative complication rates or mortalities in patients who underwent RAS compared to that expected in non-COVID practice. RAS was deemed safe, with recommendations for mitigation of risk of viral transmission. Conclusions: Continuation of RAS was feasible and safe during the SARS-CoV-2 pandemic where resources permitted. Post-pandemic reflections upon published robotic data and publication patterns allows us to better prepare for future events and to enhance urgent guideline design processes.

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

Cited by 7 publications

References 17 publications

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

Timing of surgery and elective perioperative management of patients with previous SARS-CoV-2 infection: a SIAARTI expert consensus statement

Robotic Abdominal Surgery and COVID-19: A Systematic Review of Published Literature and Peer-Reviewed Guidelines during the SARS-CoV-2 Pandemic

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