Department of Colorectal Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, SW3 6JJ, UK.
Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Updates Surg. 2022 Apr;74(2):619-628. doi: 10.1007/s13304-022-01264-y. Epub 2022 Mar 3.
The outbreak of the COVID-19 pandemic produced unprecedented challenges, at a global level, in the provision of cancer care. With the ongoing need in the delivery of life-saving cancer treatment, the surgical management of patients with colorectal cancer required prompt significant transformation. The aim of this retrospective study is to report the outcome of a bespoke regional Cancer Hub model in the delivery of elective and essential colorectal cancer surgery, at the height of the first wave of the COVID-19 pandemic. 168 patients underwent colorectal cancer surgery from April 1st to June 30th of 2020. Approximately 75% of patients operated upon underwent colonic resection, of which 47% were left-sided, 34% right-sided and 12% beyond total mesorectal excision surgeries. Around 79% of all resectional surgeries were performed via laparotomy, and the remainder 21%, robotically or laparoscopically. Thirty-day complication rate, for Clavien-Dindo IIIA and above, was 4.2%, and 30-day mortality rate was 0.6%. Re-admission rate, within 30 days post-discharge, was 1.8%, however, no patient developed COVID-19 specific complications post-operatively and up to 28 days post-discharge. The established Cancer Hub offered elective surgical care for patients with colorectal cancer in a centralised, timely and efficient manner, with acceptable post-operative outcomes and no increased risk of contracting COVID-19 during their inpatient stay. We offer a practical model of care that can be used when elective surgery "hubs" for streamlined delivery of elective care needs to be established in an expeditious fashion, either due to the COVID-19 pandemic or any other future pandemics.
新冠疫情的爆发给全球范围内的癌症治疗带来了前所未有的挑战。为了提供救命的癌症治疗，同时满足不断增长的需求，结直肠癌患者的外科治疗需要迅速进行重大转变。本回顾性研究旨在报告在新冠疫情第一波高峰期，一个专门的区域性癌症中心模式在提供选择性和必要的结直肠癌手术方面的结果。2020 年 4 月 1 日至 6 月 30 日，有 168 名患者接受了结直肠癌手术。大约 75%的手术患者接受了结肠切除术，其中 47%为左侧，34%为右侧，12%为超出全直肠系膜切除术。所有切除术的 79%左右通过剖腹手术进行，其余 21%通过机器人或腹腔镜进行。Clavien-Dindo IIIA 及以上的 30 天并发症发生率为 4.2%，30 天死亡率为 0.6%。30 天内再入院率为 1.8%，然而，没有患者在术后出现新冠病毒相关并发症，也没有患者在出院后 28 天内出现这种情况。已建立的癌症中心以集中、及时和有效的方式为结直肠癌患者提供选择性手术治疗，术后结果可接受，且在住院期间不会增加感染新冠病毒的风险。在需要迅速建立用于提供选择性治疗的“中心”的情况下，无论是由于新冠疫情还是未来的任何其他大流行，我们都提供了一种实用的护理模式。
