Surgical treatment and outcomes of colorectal cancer patients during the COVID-19 pandemic: a national population-based study in England
Authors
Kuryba, A.Boyle, J. M.
Blake, H. A.
Aggarwal, A.
van der Meulen, J.
Braun, Michael S
Walker, K
Fearnhead, N. S.
Affiliation
Clinical Effectiveness Unit, Royal College of Surgeons of England, London,Issue Date
2021
Metadata
Show full item recordAbstract
To compare the management and outcomes of colorectal cancer (CRC) patients during the first 2 months of the COVID-19 pandemic with the preceding 6 months. Background: The pandemic has affected the diagnosis and treatment of CRC patients worldwide. Little is known about the safety of major resection and whether creating "cold" sites (COVID-free hospitals) is effective. Methods: A national study in England used administrative hospital data for 14,930 CRC patients undergoing surgery between October 1, 2019, and May 31, 2020. Mortality of CRC resection was compared before and after March 23, 2020 ("lockdown" start). Results: The number of elective CRC procedures dropped sharply during the pandemic (from average 386 to 214 per week), whereas emergency procedures were hardly affected (from 88 to 84 per week). There was little change in characteristics of surgical patients during the pandemic. Laparoscopic surgery decreased from 62.5% to 35.9% for elective and from 17.7% to 9.7% for emergency resections. Surgical mortality increased slightly (from 0.9% to 1.2%, P = 0.06) after elective and markedly (from 5.6% to 8.9%, P = 0.003) after emergency resections. The observed increase in mortality during the first phase of the pandemic was similar in "cold" and "hot" sites (P > 0.5 elective and emergency procedures). Conclusions: The pandemic resulted in a 50% reduction in elective CRC procedures during the initial surge and a substantial increase in mortality after emergency resection. There was no evidence that surgery in COVID-free "cold" sites led to better outcomes in the first 2 months.Citation
Kuryba A, Boyle JM, Blake HA, Aggarwal A, van der Meulen J, Braun M, et al. Surgical Treatment and Outcomes of Colorectal Cancer Patients During the COVID-19 Pandemic: A National Population-based Study in England. Annals of Surgery Open. 2021 Jun;2(2):e071.Journal
Annals of Surgery OpenDOI
10.1097/as9.0000000000000071PubMed ID
34240077Additional Links
https://dx.doi.org/10.1097/as9.0000000000000071Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1097/as9.0000000000000071
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