Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Dong'an Road, 270, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Gastroenterol. 2021 Apr 20;21(1):185. doi: 10.1186/s12876-021-01768-8.
Since December 2019, China has experienced a public health emergency from the coronavirus disease, which has become a pandemic and is impacting the care of cancer patients worldwide. This study evaluated the impact of the pandemic on colorectal cancer (CRC) patients at our center and aimed to share the lessons we learned with clinics currently experiencing this impact.
We retrospectively collected data on CRC patients admitted between January 1, 2020 and May 3, 2020; the control group comprised patients admitted between January 1, 2019 and May 3, 2019.
During the pandemic, outpatient volumes decreased significantly, especially those of nonlocal and elderly patients, whereas the number of patients who received chemotherapy and surgery remained the same. During the pandemic, 710 CRC patients underwent curative resection. The proportion of patients who received laparoscopic surgeries was 49.4%, significantly higher than the 39.5% during the same period in 2019. The proportion of major complication during the pandemic was not significantly different from that of the control group. The mean hospital stay was significantly longer than that of the control group.
CRC patients confirmed to be infection-free can receive routine treatment. Using online medical counseling and appropriate identification, treatment and follow-up can be effectively maintained. Adjuvant and palliative chemotherapy should not be discontinued. Endoscopic polypectomy, elective, palliative, and multidisciplinary surgeries can be postponed, while curative surgery should proceed as usual. For elderly CRC patients, endoscopic surgery and neoadjuvant radiotherapy are recommended.
自 2019 年 12 月以来，中国经历了一场由冠状病毒病引发的公共卫生紧急事件，该事件已成为全球性大流行病，影响了全球癌症患者的治疗。本研究评估了疫情对我们中心结直肠癌（CRC）患者的影响，并旨在与目前正在经历这一影响的诊所分享我们所学到的经验。
我们回顾性收集了 2020 年 1 月 1 日至 2020 年 5 月 3 日期间收治的 CRC 患者的数据；对照组包括 2019 年 1 月 1 日至 2019 年 5 月 3 日期间收治的患者。
疫情期间，门诊量显著下降，尤其是非本地和老年患者的门诊量，而接受化疗和手术的患者数量保持不变。疫情期间，710 例 CRC 患者接受了根治性切除术。接受腹腔镜手术的患者比例为 49.4%，明显高于 2019 年同期的 39.5%。疫情期间主要并发症的比例与对照组无显著差异。平均住院时间明显长于对照组。
对于已确认无感染的 CRC 患者，可以接受常规治疗。通过在线医疗咨询和适当的识别、治疗和随访，可以有效地维持治疗。辅助和姑息化疗不应中断。内镜息肉切除术、择期、姑息和多学科手术可以推迟，而根治性手术应照常进行。对于老年 CRC 患者，推荐内镜手术和新辅助放疗。
