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Colorectal surgery during the COVID-19 outbreak: do we need to change?
Allaix, Marco Ettore; Lo Secco, Giacomo; Velluti, Francesco; De Paolis, Paolo; Arolfo, Simone; Morino, Mario.
Afiliación
  • Allaix ME; Department of Surgical Sciences, University of Torino, Torino, Italy. marcoettore.allaix@unito.it.
  • Lo Secco G; Department of Surgical Sciences, University of Torino, Torino, Italy.
  • Velluti F; Department of Surgery, Città della Salute e della Scienza Hospital, Torino, Italy.
  • De Paolis P; Department of Surgery, Città della Salute e della Scienza Hospital, Torino, Italy.
  • Arolfo S; Department of Surgical Sciences, University of Torino, Torino, Italy.
  • Morino M; Department of Surgical Sciences, University of Torino, Torino, Italy.
Updates Surg ; 73(1): 173-177, 2021 Feb.
Article en En | MEDLINE | ID: mdl-33387170
The outbreak of COVID-19 has led some leading surgical societies to postpone colorectal cancer resections, support the employment of low-risk strategies in patients requiring colorectal surgery, such as construction of a stoma rather than primary anastomosis, in order to minimize the risk of potentially life-threatening complications. They have also recommended against the use of the laparoscopic approach. However, the evidence supporting these recommendations is scarce. The aim of this study was to assess the outcomes of colorectal resections during the COVID-19 pandemic. This is a retrospective review of a prospective institutional database. All consecutive patients undergoing elective or emergent colorectal resections between March 9 and April 15, 2020, were compared to those treated in the same period of time in 2019. Despite an overall reduction in the surgical activity of 56.3% in 2020, the two groups were similar in terms of absolute numbers of colorectal resections, type of surgery and use of laparoscopy. The overall postoperative complications rate was similar: 20% in 2019 versus 14.9% in 2020 (p = 0.518), without any difference in terms of severity. No patient during the postoperative course got infected by COVID-19, as well as none from the surgical team. Median length of hospital stay was 5 days in both groups (p = 0.555). Postponing surgery in colorectal cancer patients and performing more stomas rather than direct anastomosis is not justified. The routine use of laparoscopy should not be abandoned, thus not depriving patients of its clinically relevant early short-term benefits over open surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Colorrectales / Laparoscopía / Colectomía / Proctectomía / COVID-19 Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Updates Surg Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Colorrectales / Laparoscopía / Colectomía / Proctectomía / COVID-19 Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Updates Surg Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia