日本一家三级医疗机构在 COVID-19 大流行期间的结直肠癌微创手术。
Minimally Invasive Surgery for Colorectal Cancer During the COVID-19 Pandemic in a Tertiary Medical Facility in Japan.
机构信息
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan;
Department of Digestive Surgery, Kyoto Okamoto Memorial Hospital, Kyoto, Japan.
出版信息
In Vivo. 2022 Nov-Dec;36(6):2806-2812. doi: 10.21873/invivo.13018.
BACKGROUND/AIM: The coronavirus disease 2019 (COVID-19) pandemic has reduced hospital visits due to concerns regarding infection and also resulted in cancer screening delays. These changes may have had an impact on the progression of colorectal cancer (CRC). Therefore, the present study investigated the effects of the COVID-19 pandemic on minimally invasive surgery (MIS) for CRC using a correlation analysis of clinical outcomes before and during the COVID-19 pandemic.
PATIENTS AND METHODS
The present study targeted CRC patients who underwent MIS between January 2018 and December 2019 (pre-COVID-19) and between April 2020 and March 2021 (COVID-19). A comparison analysis of clinical, surgical, and pathological findings between the pre-COVID-19 and COVID-19 groups was performed.
RESULTS
Ninety-one patients underwent MIS for CRC pre-COVID-19 and 67 during COVID-19. The number of CRC cases detected by fecal occult blood tests was slightly higher in the pre-COVID-19 group than that in the COVID-19 group. Re-evaluations of laparoscopic videos revealed that the number of cases of surgical T4 CRC resected with the combined resection of the adjacent organs was significantly higher in the COVID-19 group than that in the pre-COVID-19 group (16.4 vs. 4.4%, p=0.010). Furthermore, surgical times were significantly longer in the COVID-19 group than those in the pre-COVID-19 group (p<0.001). Pathological findings showed that the number of pT4 cases was significantly higher in the COVID-19 group than that in the pre-COVID-19 group (p=0.026).
CONCLUSION
The number of T4 CRC cases was higher during than before the COVID-19 pandemic, with increases in the surgical difficulty of MIS.
背景/目的：2019 年冠状病毒病（COVID-19）大流行导致人们因担心感染而减少了医院就诊次数，同时也导致癌症筛查延迟。这些变化可能对结直肠癌（CRC）的进展产生了影响。因此，本研究通过分析 COVID-19 大流行前后的临床结果，探讨了 COVID-19 大流行对 CRC 微创外科（MIS）的影响。
患者和方法
本研究以 2018 年 1 月至 2019 年 12 月（COVID-19 前）和 2020 年 4 月至 2021 年 3 月（COVID-19 期间）接受 MIS 治疗的 CRC 患者为研究对象。对 COVID-19 前组和 COVID-19 组的临床、手术和病理发现进行了比较分析。
结果
91 例患者在 COVID-19 前接受了 CRC 的 MIS 治疗，67 例患者在 COVID-19 期间接受了 MIS 治疗。COVID-19 前组粪便潜血试验检测到的 CRC 病例略高于 COVID-19 组。重新评估腹腔镜视频显示，COVID-19 组中联合切除邻近器官切除的 T4CRC 病例数量明显高于 COVID-19 前组（16.4%比 4.4%，p=0.010）。此外，COVID-19 组的手术时间明显长于 COVID-19 前组（p<0.001）。病理检查结果显示，COVID-19 组的 pT4 病例数明显高于 COVID-19 前组（p=0.026）。
结论
COVID-19 大流行期间 T4CRC 病例数量高于大流行前，MIS 手术难度增加。
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