SARS-CoV-2 大流行期间乳腺癌和结直肠癌手术的真实影响。
The real-word impact of breast and colorectal cancer surgery during the SARS-CoV-2 pandemic.
机构信息
Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
Department of Surgery, University of Trieste-Ospedale di Cattinara, 34100, Trieste, Italy.
出版信息
Updates Surg. 2022 Jun;74(3):1063-1072. doi: 10.1007/s13304-021-01212-2. Epub 2022 Jan 3.
The postponing of screening and the health care system reorganization, due to the Covid-19 pandemic and lockdown, could led to a concerning decline in breast and colorectal cancer diagnoses. This monocentric retrospective analysis has compared the pre-Covid period (March 2019 to March 2020) to the Covid period (April 2020 to April 2021) in terms of screening programs, clinical, surgical and pathological. A total of 799 patients diagnosed with Breast Cancer (BC) and Colorectal Cancer (CRC) underwent surgery during the two periods. In FVG in 2020 a decrease in mammography screening of 17.1% has been registered compared to 2019; this reduction has been higher for CRC screening, which summed up to 24.5%. As far as BC is concerned, screening-detected tumours rose significantly from 18 to 28%, mastectomies decreased from 40 to 31% and advanced tumours treated surgically decreased from 12 to 6%. Concerning CRC, a significant increase in admissions through the Emergency Department has been registered in spite of a stable percentage of urgent surgery performed, proving that severely symptomatic patients have been treated adequately. Open surgery has significantly decreased, whereas the tumoral stage and complications have remained constant in the two periods. This study has proved that maintaining standards of care and validated protocols during emergency is the most adequate and winning strategy: impact on BC and CRC has been less important than expected. These results support the recommendations for immediate and rapid screening program resumption at operating speed, using prioritization strategies to make up for the diagnostic delays.
由于新冠疫情和封锁,筛查的推迟和医疗保健系统的重组可能导致乳腺癌和结直肠癌诊断数量的显著下降。这项单中心回顾性分析比较了新冠前时期(2019 年 3 月至 2020 年 3 月)和新冠时期(2020 年 4 月至 2021 年 4 月)的筛查计划、临床、手术和病理情况。在两个时期共对 799 名接受乳腺癌(BC)和结直肠癌(CRC)手术的患者进行了分析。在 2020 年的 FVG,与 2019 年相比,乳腺 X 光筛查减少了 17.1%;CRC 筛查的减少更为显著,总计减少了 24.5%。就 BC 而言,筛查发现的肿瘤显著从 18%上升到 28%,乳房切除术从 40%下降到 31%,手术治疗的晚期肿瘤从 12%下降到 6%。就 CRC 而言,尽管紧急手术的比例保持稳定,但通过急诊收治的人数显著增加,这表明严重症状的患者得到了充分的治疗。开放性手术显著减少,而在两个时期肿瘤分期和并发症保持不变。这项研究证明,在紧急情况下维持护理标准和经过验证的方案是最合适和最有效的策略:对 BC 和 CRC 的影响比预期的要小。这些结果支持立即和快速恢复筛查计划的建议,采用优先策略来弥补诊断延误。
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