The impact of SARS-CoV-2 infection on the surgical management of colorectal cancer: lessons learned from a multicenter study in Spain

• Patricia Tejedor ^[4] ; Vicente Simó ^[5] ; Jorge Arredondo ^[1] ; Irene López-Rojo ^[6] ; Jorge Baixauli ^[2] ; Luis Miguel Jiménez ^[7] ; Marcos Gómez-Ruiz ^[3] ; Carlos Pastor ^[2] ; Project Working Group
  1. [1] Hospital Ciudad de Coria

     Hospital Ciudad de Coria

     Coria, España

     
  2. [2] Clínica Universitaria de Navarra

     Clínica Universitaria de Navarra

     Pamplona, España

     
  3. [3] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  4. [4] Hospital Central de la Defensa Gómez Ulla. Madrid, Spain
  5. [5] Hospital Universitario de León. León, Spain
  6. [6] M.D. Anderson Cancer Center. Madrid, Spain
  7. [7] Hospital Universitario Gregorio Marañón. Madrid, Spain

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 113, Nº. 2, 2021, págs. 85-91
• Idioma: inglés
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  • Objective: the aim of the study was to analyze the management of colorectal cancer (CRC) patients diagnosed with CRC or undergoing elective surgery during the period of the SARS-CoV-2 pandemic. Material and methods: a multicenter ambispective analysis was performed in nine centers in Spain during a four-month period. Data were collected from every patient, including changes in treatments, referrals or delays in surgeries, changes in surgical approaches, postoperative outcomes and perioperative SARS-CoV-2 status. The hospital’s response to the outbreak and available resources were categorized, and outcomes were divided into periods based on the timeline of the pandemic. Results: a total of 301 patients were included by the study centers and 259 (86 %) underwent surgery. Five hospitals went into phase III during the peak of incidence period, one remained in phase II and three in phase I. More than 60 % of patients suffered some form of change: 48 % referrals, 39 % delays, 4 % of rectal cancer patients had a prolonged interval to surgery and 5 % underwent neoadjuvant treatment. At the time of study closure, 3 % did not undergo surgery. More than 85 % of the patients were tested preoperatively for SARS-CoV-2. A total of nine patients (3 %) developed postoperative pneumonia; three of them had confirmed SARS-CoV-2. The observed surgical complications and mortality rates were similar as expected in a usual situation. Conclusions: the present multicenter study shows different patterns of response to the SARS-CoV-2 pandemic and collateral effects in managing CRC patients. Knowing these patterns could be useful for planning future changes in surgical departments in preparation for new outbreaks.