Ng G H, Philip Ding H L, Leow Y C, Umasangar R, Ang C W
Taiping Hospital, Department of Surgery, Perak, Malaysia.
Mahkota Medical Centre, Melaka, Malaysia.
Med J Malaysia. 2023 Jan;78(1):32-34.
The COVID-19 pandemic has led to major changes in the provision of surgical services and also affected patients' health-seeking behaviour. This contributes to delayed presentation of many surgical conditions resulting in poorer outcomes. Colorectal cancer (CRC) patients who present with acute surgical emergencies such as complete bowel obstruction, perforation, bleeding or sepsis often require immediate intervention. This study aimed to assess the impact of COVID-19 pandemic on the proportion of emergency surgery in CRC patients.
This is a retrospective cohort study. All CRC patients who underwent elective and emergency surgery from January until December 2019 (pre-COVID era) and September 2020 until August 2021 (COVID era) were included. Patient demographics, presentation, tumour stage, surgery performed and waiting time for surgery were collected. Data were then compared.
Seventy-seven and 76 new cases of CRC underwent surgery before and during COVID-19, respectively. The proportions of emergency surgery before and during COVID-19 are 29% vs 33% (p=0.562). Of those who required emergency surgery, the proportions of patients who required stoma formation are 59% vs 72% (p= 0.351). There was no difference in median waiting time for patients requiring elective surgery (p= 0.668).
The proportion of emergency surgery for CRC patients is not statistically higher during the pandemic.
新冠疫情导致外科手术服务发生重大变化,也影响了患者的就医行为。这导致许多外科疾病的就诊延迟,从而造成更差的治疗结果。出现完全性肠梗阻、穿孔、出血或脓毒症等急性外科急症的结直肠癌(CRC)患者通常需要立即干预。本研究旨在评估新冠疫情对CRC患者急诊手术比例的影响。
这是一项回顾性队列研究。纳入了2019年1月至12月(新冠疫情前时期)以及2020年9月至2021年8月(新冠疫情时期)接受择期和急诊手术的所有CRC患者。收集了患者的人口统计学信息、临床表现、肿瘤分期、所进行的手术以及手术等待时间。然后对数据进行比较。
分别有77例和76例新的CRC病例在新冠疫情之前和期间接受了手术。新冠疫情之前和期间急诊手术的比例分别为29%和33%(p = 0.562)。在那些需要急诊手术的患者中,需要造口术的患者比例分别为59%和72%(p = 0.351)。需要择期手术的患者中位等待时间没有差异(p = 0.668)。
在疫情期间,CRC患者的急诊手术比例在统计学上没有更高。