Abstract
OBJECTIVES:Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic.METHODS:This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded.RESULTS:A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (p<0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versus https://doi.org/10.3 days, respectively, p<0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%).CONCLUSION:Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.
Highlights
In December 2019, a novel coronavirus—the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—was identified as the cause of a cluster outbreak of pneumonia in Wuhan, China
All health services established elaborated changes in facing the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic, having to save resources to deal with critically ill patients infected with the new virus and prevent further in-hospital transmission of patients being treated for other causes [2,3]
The hospital protocol for elective surgery was in constant adjustment, and until June 1, asymptomatic patients were not routinely tested preoperatively for SARS-CoV-2 infection
Summary
In December 2019, a novel coronavirus—the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—was identified as the cause of a cluster outbreak of pneumonia in Wuhan, China. As a result of the rapid spread, the SARSCoV-2 infection was first reported in Brazil on February 25, 2020, and was declared a pandemic by the World Health. Received for publication on October 17, 2020. Accepted for publication on February 1, 2021. All health services established elaborated changes in facing the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic, having to save resources to deal with critically ill patients infected with the new virus and prevent further in-hospital transmission of patients being treated for other causes [2,3]. Many elective surgeries were suspended [4]; oncological and urgent surgeries were still performed whenever possible [5]
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