Kędzierska-Kapuza Karolina, Witkowski Grzegorz, Baumgart-Gryn Katarzyna, Szylińska Aleksandra, Durlik Marek
Department of Gastroenterological Surgery and Transplantology, Center of Postgraduate Medical Education in Warsaw, Poland.
Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland.
Adv Clin Exp Med. 2022 Apr;31(4):389-398. doi: 10.17219/acem/144134.
A total of 148 surgeries were performed in our center on patients with pancreatic cancer in 2020. In 2019, 263 such procedures were performed (77.7% more) in this facility.
To analyze the impact of coronavirus disease 2019 (COVID-19) on pancreatic cancer surgery type, number and outcome in our center.
Retrospective data analysis of medical documentation in a hospital database from January 2019 till December 2020.
In 2020, we observed an increase of tumors localized in the tail of the pancreas (P) - 29 cases (19.9%) in 2020 compared to 26 cases (9.9%) in 2019 (p = 0.005). In 2020, our patients presented with much greater advancement of the disease illustrated by the increased tumor size (median 3.5 cm in 2020 compared to 3.0 cm in 2019), although it did not reach statistical significance (p = 0.073). In 2020, we performed more palliative procedures, e.g., bypassing anastomoses (17 (11.6%) in 2020 compared to 8 (3%) in 2019 (p < 0.001)), more open biopsies of P (21 (14.4%) in 2020 compared to 21 (7.9%) in 2019 (p = 0.041)), and more percutaneous biopsies of P (7 (4.8%) in 2020 and 0 in 2019 (p = 0.001)). We observed a significant decrease in the number of Whipple procedures (53 (36.3%) in 2020 and 125 (47.5%) in 2019 (p = 0.037)). The most common histopathological finding was adenocarcinoma of the P, accounting for 50% in 2020 and almost 52% of all tumor cases in 2019. In a group of 148 patients operated on due to a P tumor during the COVID-19 pandemic, only 6 patients died, which resulted in a mortality rate of 4.1% compared to 13.4% mortality rate in 2019 (34 deaths/263 patients; p = 0.005). We observed less leakage of gastrointestinal anastomosis (0/148 in 2020 and 10/263 in 2019 (p = 0.038)).
Particular attention should be paid to patients with an aggressive type of cancer who have completed neoadjuvant therapy, as they are unable to undergo other therapeutic options. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive cancer patients should be postponed until recovery. Relatively few postoperative complications and low all-cause mortality are the result of a more careful selection of oncological patients before the admission to the surgical ward, as well as a ompliance with the principles of planning the procedure and organization of the operating theater during the COVID-19 pandemic.
2020年，我们中心共对胰腺癌患者进行了148例手术。2019年，该机构进行了263例此类手术（增加了77.7%）。
分析2019冠状病毒病（COVID-19）对我们中心胰腺癌手术类型、数量和结果的影响。
对2019年1月至2020年12月医院数据库中的医疗记录进行回顾性数据分析。
2020年，我们观察到胰腺尾部肿瘤数量增加（P）——2020年为29例（19.9%），而2019年为26例（9.9%）（p = 0.005）。2020年，我们的患者疾病进展程度更高，表现为肿瘤大小增加（2020年中位数为3.5厘米，2019年为3.0厘米），尽管未达到统计学意义（p = 0.073）。2020年，我们进行了更多的姑息性手术，例如，旁路吻合术（2020年为17例（11.6%），2019年为8例（3%）（p < 0.001）），更多的胰腺开放活检（2020年为21例（14.4%），2019年为21例（7.9%）（p = 0.041）），以及更多的胰腺经皮活检（2020年为7例（4.8%），2019年为0例（p = 0.001））。我们观察到惠普尔手术数量显著减少（2020年为53例（36.3%），2019年为125例（47.5%）（p = 0.037））。最常见的组织病理学发现是胰腺腺癌，2020年占50%，2019年占所有肿瘤病例的近52%。在COVID-19大流行期间因胰腺肿瘤接受手术的148例患者中，仅6例死亡，死亡率为4.1%，而2019年死亡率为13.4%（34例死亡/263例患者；p = 0.005）。我们观察到胃肠道吻合口漏较少（2020年为0/148例，2019年为10/263例（p = 0.038））。
应特别关注已完成新辅助治疗的侵袭性癌症患者，因为他们无法接受其他治疗选择。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性的癌症患者应推迟至康复。术后并发症相对较少且全因死亡率较低是COVID-19大流行期间在肿瘤患者入院前进行更仔细筛选以及遵守手术规划原则和手术室组织原则的结果。
