Wang Qiuxiang, Wu Ruike, Wang Juan, Li Yilin, Xiong Qin, Xie Fengjiao, Feng Peimin
Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Department of Traditional Chinese Medicine, The Central Hospital of Guangyuan City, Sichuan, China.
Front Oncol. 2023 Jul 17;13:1163333. doi: 10.3389/fonc.2023.1163333. eCollection 2023.
The ongoing coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented pressure on the healthcare systems. This study evaluated the safety of colorectal cancer (CRC) surgery during the COVID-19 pandemic.
A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO ID: CRD 42022327968). Relevant articles were systematically searched in the PubMed, Embase, Web of Science, and Cochrane databases. The postoperative complications, anastomotic leakage, postoperative mortality, 30-day readmission, tumor stage, total hospitalization, postoperative hospitalization, preoperative waiting, operation time, and hospitalization in the intensive care unit (ICU) were compared between the pre-pandemic and during the COVID-19 pandemic periods.
Among the identified 561 articles, 12 met the inclusion criteria. The data indicated that preoperative waiting time related to CRC surgery was higher during the COVID-19 pandemic (MD, 0.99; 95%CI, 0.71-1.28; p < 0.00001). A similar trend was observed for the total operative time (MD, 25.07; 95%CI, 11.14-39.00; p =0.0004), and on T4 tumor stage during the pandemic (OR, 1.77; 95%CI, 1.22-2.59; p=0.003). However, there was no difference in the postoperative complications, postoperative 90-day mortality, anastomotic leakage, and 30-day readmission times between pre-COVID-19 pandemic and during the COVID-19 pandemic periods. Furthermore, there was no difference in the total hospitalization time, postoperative hospitalization time, and hospitalization time in ICU related to CRC surgery before and during the COVID-19 pandemic.
The COVID-19 pandemic did not affect the safety of CRC surgery. The operation of CRC during the COVID-19 pandemic did not increase postoperative complications, postoperative 90-day mortality, anastomotic leakage, 30-day readmission, the total hospitalization time, postoperative hospitalization time, and postoperative ICU hospitalization time. However, the operation of CRC during COVID-19 pandemic increased T4 of tumor stage during the COVID-19 pandemic. Additionally, the preoperative waiting and operation times were longer during the COVID-19 pandemic. This provides a reference for making CRC surgical strategy in the future.
https://www.crd.york.ac.uk/prospero/, identifier CRD42022327968.
持续的2019冠状病毒病（COVID-19）大流行给医疗系统带来了前所未有的压力。本研究评估了COVID-19大流行期间结直肠癌（CRC）手术的安全性。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南（PROSPERO识别号：CRD 42022327968）进行系统评价和Meta分析。在PubMed、Embase、科学网和Cochrane数据库中系统检索相关文章。比较了大流行前和COVID-19大流行期间的术后并发症、吻合口漏、术后死亡率、30天再入院率、肿瘤分期、总住院时间、术后住院时间、术前等待时间、手术时间和重症监护病房（ICU）住院时间。
在识别出的561篇文章中，12篇符合纳入标准。数据表明，COVID-19大流行期间与CRC手术相关的术前等待时间更长（MD，0.99；95%CI，0.71-1.28；p<0.00001）。总手术时间（MD，25.07；95%CI，11.14-39.00；p =0.0004）以及大流行期间T4肿瘤分期也观察到类似趋势（OR，1.77；95%CI，1.22-2.59；p=0.003）。然而，COVID-19大流行前和COVID-19大流行期间的术后并发症、术后90天死亡率、吻合口漏和30天再入院时间没有差异。此外，COVID-19大流行前和期间与CRC手术相关的总住院时间、术后住院时间和ICU住院时间没有差异。
COVID-19大流行并未影响CRC手术的安全性。COVID-19大流行期间CRC手术并未增加术后并发症、术后90天死亡率、吻合口漏、30天再入院率、总住院时间、术后住院时间和术后ICU住院时间。然而，COVID-19大流行期间CRC手术增加了COVID-19大流行期间的肿瘤T4分期。此外，COVID-19大流行期间术前等待时间和手术时间更长。这为未来制定CRC手术策略提供了参考。
