Dai Xuan, Ding Wenjun, He Yongshan, Huang Shiyong, Liu Yun, Wu Tingyu
Department of Colorectal and Anal Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Cancers (Basel). 2023 Oct 3;15(19):4841. doi: 10.3390/cancers15194841.
With the emergence of novel variants, there have been widespread COVID-19 infections in the Chinese mainland recently. Compared to ancestral COVID-19 variants, Omicron variants become more infectious, but less virulent. Previous studies have recommended postponing non-emergency surgery for at least 4-8 weeks after COVID-19 infection. However, delayed surgery has been shown to be associated with tumor progression and worse overall survival for cancer patients. Here, we examined surgery risk and optimal timing for colorectal cancer patients with perioperative COVID-19 infection. A total of 211 patients who underwent colorectal cancer surgery from 1 October 2022 to 20 January 2023 at Xinhua Hospital were included. In addition, COVID-19-infected patients were further categorized into three groups based on infected time (early post-COVID-19 group, late post-COVID-19 group and postoperative COVID-19 group). The complication rate in patients with COVID-19 infection was 26.3%, which was significantly higher than in control patients (8.4%). The most common complications in COVID-19-infected patients were pneumonia, ileus and sepsis. Patients who underwent surgery close to the time of infection had increased surgery risks, whereas surgery performed over 1 week after recovery from COVID-19 did not increase the risk of postoperative complications. In conclusion, surgery performed during or near the time of COVID-19 infection is associated with an increased risk of developing postoperative complications. We recommend that the safe period for patients with recent COVID-19 infection in colorectal cancer surgery be at least 1 week after recovery from COVID-19.
随着新型变种的出现,中国大陆最近出现了广泛的新冠病毒感染。与新冠病毒原始变种相比,奥密克戎变种的传染性更强,但毒性较弱。先前的研究建议在新冠病毒感染后至少推迟4至8周进行非紧急手术。然而,延迟手术已被证明与癌症患者的肿瘤进展和总体生存率降低有关。在此,我们研究了围手术期感染新冠病毒的结直肠癌患者的手术风险和最佳手术时机。纳入了2022年10月1日至2023年1月20日在新华医院接受结直肠癌手术的211例患者。此外,新冠病毒感染患者根据感染时间进一步分为三组(新冠病毒感染后早期组、新冠病毒感染后晚期组和术后新冠病毒感染组)。新冠病毒感染患者的并发症发生率为26.3%,显著高于对照组患者(8.4%)。新冠病毒感染患者最常见的并发症是肺炎、肠梗阻和败血症。在感染时间附近进行手术的患者手术风险增加,而在从新冠病毒感染中恢复超过1周后进行手术不会增加术后并发症的风险。总之,在新冠病毒感染期间或附近进行手术与术后并发症发生风险增加有关。我们建议,结直肠癌手术中近期感染新冠病毒的患者的安全期为从新冠病毒感染中恢复后至少1周。