Maintaining Standards in Colorectal Cancer Surgery During the Global Pandemic: A Cohort Study.
Identifieur interne : 000299 ( Main/Exploration ); précédent : 000298; suivant : 000300Maintaining Standards in Colorectal Cancer Surgery During the Global Pandemic: A Cohort Study.
Auteurs : Julia Merchant [Royaume-Uni] ; Ian Lindsey [Royaume-Uni] ; David James [Royaume-Uni] ; Nick Symons [Royaume-Uni] ; Stephen Boyce [Royaume-Uni] ; Oliver Jones [Royaume-Uni] ; Bruce George [Royaume-Uni] ; Chris Cunningham [Royaume-Uni]Source :
- World journal of surgery [ 1432-2323 ] ; 2021.
Abstract
AIM
Cancer surgery in the COVID-19 pandemic presents many new challenges. For each patient, the risk of contracting COVID-19 during the perioperative period, with the potential for life-threatening sequelae (1), has to be weighed against the risk of delaying treatment. We assessed the response and short-term outcomes from elective colorectal cancer surgery during the pandemic at our institution.
METHOD
We report a prospective cohort study of all elective colorectal surgery cases performed at our Trust during the 11 weeks following the national UK lockdown on 23rd March 2020, compared with the same time period in 2019.
RESULTS
Eighty-five colorectal operations were performed during the 2020 (COVID) time period, and 179 performed in the 2019 (non-COVID) time period. A significantly higher proportion of cases during the COVID period were cancer-related (66% vs 26%, p < 0.00001). There was no difference in length of hospital stay, complications or readmissions. There were no mortalities in either cohort. Among the cancer patients, there were no differences in TMN staging, R1 resection rate or lymph node yields. No elective patient tested positive for COVID-19 during the perioperative period.
CONCLUSION
At the height of the COVID pandemic, we maintained delivery the of high-quality elective colorectal cancer surgery, with no worsening of short-term outcomes and no compromise in the quality of cancer resections. Ongoing monitoring of this cohort is essential. The risks associated with COVID-19 will continue for some time, necessitating adaptive responses to maintain high-quality cancer services.
DOI: 10.1007/s00268-020-05928-x
PubMed: 33423099
PubMed Central: PMC7796814
Affiliations:
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nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Symons, Nick" sort="Symons, Nick" uniqKey="Symons N" first="Nick" last="Symons">Nick Symons</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Boyce, Stephen" sort="Boyce, Stephen" uniqKey="Boyce S" first="Stephen" last="Boyce">Stephen Boyce</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country 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Bruce" uniqKey="George B" first="Bruce" last="George">Bruce George</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Cunningham, Chris" sort="Cunningham, Chris" uniqKey="Cunningham C" first="Chris" last="Cunningham">Chris Cunningham</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, 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sortKey="Merchant, Julia" sort="Merchant, Julia" uniqKey="Merchant J" first="Julia" last="Merchant">Julia Merchant</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK. juliafmerchant@gmail.com.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Lindsey, Ian" sort="Lindsey, Ian" uniqKey="Lindsey I" first="Ian" last="Lindsey">Ian Lindsey</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="James, David" sort="James, David" uniqKey="James D" first="David" last="James">David James</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Symons, Nick" sort="Symons, Nick" uniqKey="Symons N" first="Nick" last="Symons">Nick Symons</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Boyce, Stephen" sort="Boyce, Stephen" uniqKey="Boyce S" first="Stephen" last="Boyce">Stephen Boyce</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Jones, Oliver" sort="Jones, Oliver" uniqKey="Jones O" first="Oliver" last="Jones">Oliver Jones</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="George, Bruce" sort="George, Bruce" uniqKey="George B" first="Bruce" last="George">Bruce George</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Cunningham, Chris" sort="Cunningham, Chris" uniqKey="Cunningham C" first="Chris" last="Cunningham">Chris Cunningham</name><affiliation wicri:level="3"><nlm:affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author></analytic><series><title level="j">World journal of surgery</title><idno type="eISSN">1432-2323</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>AIM</b></p><p>Cancer surgery in the COVID-19 pandemic presents many new challenges. For each patient, the risk of contracting COVID-19 during the perioperative period, with the potential for life-threatening sequelae (1), has to be weighed against the risk of delaying treatment. We assessed the response and short-term outcomes from elective colorectal cancer surgery during the pandemic at our institution.</p></div><div type="abstract" xml:lang="en"><p><b>METHOD</b></p><p>We report a prospective cohort study of all elective colorectal surgery cases performed at our Trust during the 11 weeks following the national UK lockdown on 23rd March 2020, compared with the same time period in 2019.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Eighty-five colorectal operations were performed during the 2020 (COVID) time period, and 179 performed in the 2019 (non-COVID) time period. A significantly higher proportion of cases during the COVID period were cancer-related (66% vs 26%, p < 0.00001). There was no difference in length of hospital stay, complications or readmissions. There were no mortalities in either cohort. Among the cancer patients, there were no differences in TMN staging, R1 resection rate or lymph node yields. No elective patient tested positive for COVID-19 during the perioperative period.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>At the height of the COVID pandemic, we maintained delivery the of high-quality elective colorectal cancer surgery, with no worsening of short-term outcomes and no compromise in the quality of cancer resections. Ongoing monitoring of this cohort is essential. The risks associated with COVID-19 will continue for some time, necessitating adaptive responses to maintain high-quality cancer services.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33423099</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>12</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-2323</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jan</Month><Day>09</Day></PubDate></JournalIssue><Title>World journal of surgery</Title><ISOAbbreviation>World J Surg</ISOAbbreviation></Journal><ArticleTitle>Maintaining Standards in Colorectal Cancer Surgery During the Global Pandemic: A Cohort Study.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00268-020-05928-x</ELocationID><Abstract><AbstractText Label="AIM" NlmCategory="OBJECTIVE">Cancer surgery in the COVID-19 pandemic presents many new challenges. For each patient, the risk of contracting COVID-19 during the perioperative period, with the potential for life-threatening sequelae (1), has to be weighed against the risk of delaying treatment. We assessed the response and short-term outcomes from elective colorectal cancer surgery during the pandemic at our institution.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">We report a prospective cohort study of all elective colorectal surgery cases performed at our Trust during the 11 weeks following the national UK lockdown on 23rd March 2020, compared with the same time period in 2019.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Eighty-five colorectal operations were performed during the 2020 (COVID) time period, and 179 performed in the 2019 (non-COVID) time period. A significantly higher proportion of cases during the COVID period were cancer-related (66% vs 26%, p < 0.00001). There was no difference in length of hospital stay, complications or readmissions. There were no mortalities in either cohort. Among the cancer patients, there were no differences in TMN staging, R1 resection rate or lymph node yields. No elective patient tested positive for COVID-19 during the perioperative period.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">At the height of the COVID pandemic, we maintained delivery the of high-quality elective colorectal cancer surgery, with no worsening of short-term outcomes and no compromise in the quality of cancer resections. Ongoing monitoring of this cohort is essential. The risks associated with COVID-19 will continue for some time, necessitating adaptive responses to maintain high-quality cancer services.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Merchant</LastName><ForeName>Julia</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK. juliafmerchant@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lindsey</LastName><ForeName>Ian</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>James</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Symons</LastName><ForeName>Nick</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boyce</LastName><ForeName>Stephen</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jones</LastName><ForeName>Oliver</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>George</LastName><ForeName>Bruce</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cunningham</LastName><ForeName>Chris</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>World J Surg</MedlineTA><NlmUniqueID>7704052</NlmUniqueID><ISSNLinking>0364-2313</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>12</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>10</Day><Hour>20</Hour><Minute>50</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33423099</ArticleId><ArticleId IdType="doi">10.1007/s00268-020-05928-x</ArticleId><ArticleId IdType="pii">10.1007/s00268-020-05928-x</ArticleId><ArticleId IdType="pmc">PMC7796814</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Anaesthesia. 2020 Jun;75(6):785-799</Citation><ArticleIdList><ArticleId IdType="pubmed">32221970</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Oncol. 2020 Aug;31(8):1065-1074</Citation><ArticleIdList><ArticleId IdType="pubmed">32442581</ArticleId></ArticleIdList></Reference><Reference><Citation>EClinicalMedicine. 2020 Apr 05;21:100331</Citation><ArticleIdList><ArticleId 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IdType="pubmed">32532710</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li></region><settlement><li>Oxford</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Merchant, Julia" sort="Merchant, Julia" uniqKey="Merchant J" first="Julia" last="Merchant">Julia Merchant</name></region><name sortKey="Boyce, Stephen" sort="Boyce, Stephen" uniqKey="Boyce S" first="Stephen" last="Boyce">Stephen Boyce</name><name sortKey="Cunningham, Chris" sort="Cunningham, Chris" uniqKey="Cunningham C" first="Chris" last="Cunningham">Chris Cunningham</name><name sortKey="George, Bruce" sort="George, Bruce" uniqKey="George B" first="Bruce" last="George">Bruce George</name><name sortKey="James, David" sort="James, David" uniqKey="James D" first="David" last="James">David James</name><name sortKey="Jones, Oliver" sort="Jones, Oliver" uniqKey="Jones O" first="Oliver" last="Jones">Oliver Jones</name><name sortKey="Lindsey, Ian" sort="Lindsey, Ian" uniqKey="Lindsey I" first="Ian" last="Lindsey">Ian Lindsey</name><name sortKey="Symons, Nick" sort="Symons, Nick" uniqKey="Symons N" first="Nick" last="Symons">Nick Symons</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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