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评估在 COVID-19 大流行期间进行择期胃肠道癌症手术的可行性:一家三级转诊大流行医院的 60 天随访结果的观察性研究。

Evaluating the feasibility of performing elective gastrointestinal cancer surgery during the COVID-19 pandemic: An observational study with 60 days follow-up results of a tertiary referral pandemic hospital.

机构信息

Division of Gastroenterological Surgery, Department of General Surgery, Adana City Training and Research Hospital, Health Sciences University, Adana, Turkey.

出版信息

J Surg Oncol. 2021 Mar;123(4):834-841. doi: 10.1002/jso.26396. Epub 2021 Feb 9.

DOI:10.1002/jso.26396
PMID:33559133
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8013399/
Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has interfered with the treatment algorithm for patients with gastrointestinal (GIS) cancer, resulting in deferral of surgery. We presented the outcomes of our patients to evaluate whether surgery could be safely performed and followed-up without delaying any stage of GIS cancer during the pandemic.

METHODS

This was an observational study of 177 consecutive patients who underwent elective GIS cancer surgery between March 11 and November 1, 2020. They were assessed regarding their perioperative and 60 days follow-up results for either surgical or COVID-19 status. Morbidity was determined according to the Clavien-Dindo classification (CDC). Continuous and categorical data were presented as median ± SD and number with percentage (%), respectively.

RESULTS

The study included 44 gastric, 33 pancreatic, 40 colon, and 59 rectal cancer patients. All patients underwent surgery and received neo/adjuvant treatments without delay. The overall morbidity (CDC grade II-IV) and mortality rates were 10.1% and 3.9%, respectively. None of the patients or medical staff were infected with COVID-19 during the study period.

CONCLUSION

GIS cancer surgery can be safely performed even within a pandemic hospital if proper isolation measures can be achieved for both patients and health workers. Regardless of the tumor stage, surgery should not be deferred, depending on unstandardized algorithms.

摘要

背景

2019 年冠状病毒病(COVID-19)大流行干扰了胃肠道(GIS)癌症患者的治疗方案,导致手术推迟。我们报告了我们的患者的结果,以评估在大流行期间是否可以安全地进行手术,并且不会延误 GIS 癌症的任何阶段进行随访。

方法

这是一项对 177 例连续接受 GIS 癌症择期手术的患者的观察性研究,这些手术于 2020 年 3 月 11 日至 11 月 1 日进行。根据手术或 COVID-19 状态评估其围手术期和 60 天随访结果。根据 Clavien-Dindo 分类(CDC)确定发病率。连续和分类数据分别表示为中位数±SD 和数字与百分比(%)。

结果

该研究包括 44 例胃癌、33 例胰腺癌、40 例结肠癌和 59 例直肠癌患者。所有患者均接受了手术,并在没有延迟的情况下接受了新辅助/辅助治疗。总发病率(CDC 分级 II-IV)和死亡率分别为 10.1%和 3.9%。在研究期间,没有患者或医务人员感染 COVID-19。

结论

如果可以为患者和医务人员实现适当的隔离措施,即使在大流行医院中,GIS 癌症手术也可以安全进行。无论肿瘤分期如何,都不应根据非标准化算法推迟手术。

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