Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

• Published in: Clinics (São Paulo, Brazil) Vol. 76; p. e2507
• Main Authors: Sobrado, Lucas Faraco, Nahas, Caio Sergio Rizkallah, Marques, Carlos Frederico Sparapan, Cotti, Guilherme Cutait de Castro, Imperiale, Antônio Rocco, Averbach, Pedro, Meira, José Donizeti de, Horvat, Natally, Ribeiro-Júnior, Ulysses, Cecconello, Ivan, Nahas, Sergio Carlos
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Elsevier España, S.L.U 01.01.2021; Faculdade de Medicina / USP; Elsevier España
• Subjects: Colorectal Neoplasms; Colorectal Surgery; Coronavirus infections; COVID-19; Cross-Sectional Studies; Elective Surgical Procedures - adverse effects; Humans; Inflammatory Bowel Diseases; MEDICINE, GENERAL & INTERNAL; Original; Pandemics; Retrospective Studies; SARS-CoV-2; COVID-19; Colorectal Neoplasms; Coronavirus infections; Colorectal Surgery; Inflammatory Bowel Diseases
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.6061/clinics/2021/e2507

Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (p<0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versushttps://doi.org/10.3 days, respectively, p<0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.