Department of General Surgery, United Lincolnshire Hospital NHS Trust, Pilgrim Hospital, Boston, UK.
Department of General Surgery, United Lincolnshire Hospital NHS Trust, Pilgrim Hospital, Boston, UK.
Surgeon. 2021 Oct;19(5):e183-e192. doi: 10.1016/j.surge.2020.09.015. Epub 2020 Dec 9.
In March 2020 NHS England issued guidelines recognizing the elective component of cancer surgeries may be 'curtailed', due to staffing and supply shortages during the COVID-19 pandemic. However, it suggested, 'local solutions' should be sought in order to protect the delivery of cancer services. We aimed to compare surgeons' practice for the provision of colorectal (CR) cancer surgery across the United Kingdom (UK), against updated Joint Royal Colleges & ACPGBI guidelines and highlight differences in practice, if any.
An online survey was conducted. It examined surgical practice across the UK against current protocols for CR cancer surgeries, during the COVID-19 pandemic.
29 individual responses were received from 23 NHS Trusts across the UK. 23/29 (79%) surgeons ceased or experienced delays in their CR cancer surgeries during the pandemic, with 3/29 (10%) yet to reintroduce these services. 19/26 (73%) surgeons instructed their patients to self-isolate prior to surgery, of which 5/19 (26%) correctly enforced a duration of 14 days. 10/19 (53%) participants adhered to guidelines of performing a CT chest within 24 h of surgery. 10/26 (38%) participants believe their patients are experiencing longer hospital admissions in the COVID-19 setting.
This snap shot survey highlights the dramatic variations in CR cancer surgery practice within the UK and inconsistent adherence to protocols. Guidelines will no doubt change as our knowledge of COVID-19 increases both nationally and internationally. It is essential CR surgeons keep up to date with changes in guidance, so uniformity in practice can be maintained.
2020 年 3 月，英国国民保健制度（NHS）英格兰发布指南，承认由于 COVID-19 大流行期间人员和供应短缺，癌症手术的择期部分可能“缩减”。然而，它建议应寻求“本地解决方案”，以保护癌症服务的提供。我们旨在比较英国（UK）各地外科医生提供结直肠癌（CR）癌症手术的实践情况，以符合最新的联合皇家学院和 ACPGBI 指南，并突出实践中的差异（如果有）。
进行了在线调查。它考察了在 COVID-19 大流行期间，英国各地的外科手术实践是否符合 CR 癌症手术的现行方案。
从英国 23 家 NHS 信托机构共收到 29 份个人回复。在大流行期间，29 名外科医生中的 23 名（79%）停止或延迟了他们的 CR 癌症手术，其中 3 名（10%）尚未重新开展这些服务。26 名外科医生中的 19 名（73%）指示他们的患者在手术前进行自我隔离，其中 5 名（26%）正确地实施了 14 天的隔离期。19 名外科医生中的 10 名（53%）遵守了在手术前 24 小时内进行胸部 CT 的指南。26 名外科医生中的 10 名（38%）认为他们的患者在 COVID-19 环境下住院时间更长。
这项快照调查强调了英国 CR 癌症手术实践中的显著差异，以及对方案的不一致遵守。随着我们对 COVID-19 的认识在国内外不断提高，指南无疑会发生变化。CR 外科医生必须及时了解指南的变化，以保持实践的一致性。
