@article{a1271345046247e6a9da477f16b1d0f4,
title = "Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic",
abstract = "Aim: This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method: This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results: From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion: Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks.",
keywords = "COVID-19, SARS-CoV-2, cancer, colon cancer, pandemic, rectal cancer, surgery, surgical oncology",
author = "{COVIDSurg Collaborative} and Glasbey, {James C.} and Dmitri Nepogodiev and Simoes, {Joana F. F.} and Omar, {Omar M.} and Venn, {Mary L.} and Evans, {Jonathan P.} and Kaori Futaba and Knowles, {Charles H.} and Ana Minaya-Bravo and Helen Mohan and Manish Chand and Peter Pockney and {di Saverio}, Salomone and Neil Smart and Abigail Vallance and Dale Vimalachandran and Wilkin, {Richard J. W.} and Kwabena Siaw-Acheampong and Benson, {Ruth A.} and Edward Bywater and Daoud Chaudhry and Dawson, {Brett E.} and Glasbey, {James C.} and Gujjuri, {Rohan R.} and Emily Heritage and Jones, {Conor S.} and Kamarajah, {Sivesh K.} and Chetan Khatri and Khaw, {Rachel A.} and Keatley, {James M.} and Andrew Knight and Samuel Lawday and Mann, {Harvinder S.} and Marson, {Ella J.} and McLean, {Kenneth A.} and Mckay, {Siobhan C.} and Mills, {Emily C.} and Dmitri Nepogodiev and Gianluca Pellino and Maria Picciochi and Taylor, {Elliott H.} and S. Chen and H. Zhang and E. Marra and R. Hompes and P. Ramesh and M. Nassif and S. Ibrahim and M. Youssef and M. Michel",
note = "Funding Information: This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) using UK aid from the UK Government to support global health research, The Association of Coloproctology of Great Britain and Ireland, Bowel & Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society; European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland and Yorkshire Cancer Research. The funders had no role in study design, data collection, analysis and interpretation or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care. Funding Information: This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) using UK aid from the UK Government to support global health research, The Association of Coloproctology of Great Britain and Ireland, Bowel & Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society; European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland and Yorkshire Cancer Research. The funders had no role in study design, data collection, analysis and interpretation or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2020 The Association of Coloproctology of Great Britain and Ireland Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = mar,
day = "1",
doi = "https://doi.org/10.1111/codi.15431",
language = "English",
volume = "23",
pages = "732--749",
journal = "Colorectal disease",
issn = "1462-8910",
publisher = "Wiley-Blackwell",
number = "3",
}