Soop Mattias, Anderin Kajsa, Syk Erik, Nygren Jonas, Segelman Josefin
Department of Inflammatory Bowel Disease and Intestinal Failure Surgery, Karolinska University Hospital, Stockholm, Sweden.
Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
J Surg Oncol. 2025 Jul;132(1):168-174. doi: 10.1002/jso.28094. Epub 2025 Jan 21.
Stockholm, Sweden had among the highest excess mortality rates during the first wave of the SARS-CoV-2 pandemic. In March 2020, an entire hospital implemented an infection-free cold site infrastructure and scaled up imperative mainly colorectal cancer surgery, for the Stockholm health care region. The study evaluated the efficacy of the concept.
Strict preadmission screening and prophylactic interventions were implemented. The outcomes of the cold site cohort (30th March-21st June 2020) were compared to a prepandemic control. Population-based data on colorectal cancer patients were collected from the Swedish Colorectal Cancer Registry.
There were 107 patients in the cold site cohort and 109 in the control cohort. None developed COVID-19 within 30 days postoperatively. The proportions of pelvic and laparoscopic surgery were similar. The cold site cohort had more potentially avoidable stomas (32/94 (34%) vs 19/91 (21%), p = 0.0442). In the region, the proportion of colorectal cancer resections at the cold site increased from prepandemic 12.9% (58 of 448) to 43.3% (94 of 217) (p < 0.001).
A SARS-CoV-2-cold site can be kept infection-free by screening, allowing increased volumes of colorectal cancer surgery with outcomes comparable to prepandemic practice. The cold site model should be more widely adopted in future similar scenarios.
This study reports on the implementation of an entire cold site hospital for imperative colorectal surgery, in particular colorectal cancer, during the SARS-CoV-2 pandemic. By comparing outcomes to prepandemic practices, we demonstrated that the cold site hospital was effective in preventing infection and safely increasing surgical volume many-fold.
在新冠病毒大流行的第一波期间，瑞典斯德哥尔摩的超额死亡率位居前列。2020年3月，一家医院为斯德哥尔摩医疗保健地区建立了一个无感染的冷场基础设施，并扩大了包括主要是结直肠癌手术在内的紧急手术规模。该研究评估了这一概念的效果。
实施了严格的入院前筛查和预防性干预措施。将冷场队列（2020年3月30日至6月21日）的结果与疫情前的对照组进行比较。从瑞典结直肠癌登记处收集基于人群的结直肠癌患者数据。
冷场队列中有107例患者，对照组中有109例患者。术后30天内均未发生新冠病毒感染。盆腔手术和腹腔镜手术的比例相似。冷场队列中有更多潜在可避免的造口（32/94（34%）对19/91（21%），p = 0.0442）。在该地区，冷场进行的结直肠癌切除术比例从疫情前的12.9%（448例中的58例）增加到43.3%（217例中的94例）（p < 0.001）。
通过筛查，新冠病毒冷场可保持无感染状态，从而增加结直肠癌手术量，其结果与疫情前的做法相当。冷场模式应在未来类似情况下更广泛地采用。
本研究报告了在新冠病毒大流行期间，一家医院为紧急结直肠癌手术，特别是结直肠癌，建立了一个完整的冷场医院。通过将结果与疫情前的做法进行比较，我们证明冷场医院在预防感染和安全地将手术量提高数倍方面是有效的。
