Corona virus disease 2019に罹患した進行胃癌患者に対する手術経験
新型コロナウイルス感染症（corona virus disease 2019；以下，COVID-19と略記）の感染拡大に伴い，COVID-19罹患歴のある癌患者に対して外科的治療を行う機会の増加が予想される．手術リスクの観点から，待機可能な手術はCOVID-19診断から7週目以降に予定することが推奨されているが，癌の進行や緊急性により7週の待機が困難な場合もあり，その場合の院内感染対策を含む周術期管理については十分に確立されていない．今回，我々は手術前にCOVID-19に罹患した進行胃癌患者に対し，COVID-19罹患後6週後に院内感染対策を講じて手術加療を行った症例を経験したので報告する．...
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| Published in | 日本消化器外科学会雑誌 Vol. 55; no. 5; pp. 317 - 323 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本消化器外科学会
01.05.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2021.0104 |
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| Abstract | 新型コロナウイルス感染症（corona virus disease 2019；以下，COVID-19と略記）の感染拡大に伴い，COVID-19罹患歴のある癌患者に対して外科的治療を行う機会の増加が予想される．手術リスクの観点から，待機可能な手術はCOVID-19診断から7週目以降に予定することが推奨されているが，癌の進行や緊急性により7週の待機が困難な場合もあり，その場合の院内感染対策を含む周術期管理については十分に確立されていない．今回，我々は手術前にCOVID-19に罹患した進行胃癌患者に対し，COVID-19罹患後6週後に院内感染対策を講じて手術加療を行った症例を経験したので報告する． |
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| AbstractList | 新型コロナウイルス感染症（corona virus disease 2019；以下，COVID-19と略記）の感染拡大に伴い，COVID-19罹患歴のある癌患者に対して外科的治療を行う機会の増加が予想される．手術リスクの観点から，待機可能な手術はCOVID-19診断から7週目以降に予定することが推奨されているが，癌の進行や緊急性により7週の待機が困難な場合もあり，その場合の院内感染対策を含む周術期管理については十分に確立されていない．今回，我々は手術前にCOVID-19に罹患した進行胃癌患者に対し，COVID-19罹患後6週後に院内感染対策を講じて手術加療を行った症例を経験したので報告する． |
| Author | 大原, 信福 西川, 和宏 西尾, 智尋 前田, 栄 中田, 健 中平, 伸 三宅, 祐一朗 安原, 裕美子 牛丸, 裕貴 宮本, 敦史 中西, 智也 川端, 良平 小川, 吉彦 |
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| References | 22) European Centre for Disease Prevention and control (ECDC). Guidance for discharge and ending of isolation of people with COVID-19 [Internet]. European Union. [updated 2020 October 16]. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Guidance-for-discharge-and-ending-of-isolation-of-people-with-COVID-19.pdf 18) Terashima M, Yoshikawa T, Boku N, Ito S, Tsuburaya A, Iwasaki Y, et al. Current status of perioperative chemotherapy for locally advanced gastric cancer and JCOG perspectives. Jpn J Clin Oncol. 2020;50(5):528–534. 5) 新型コロナウイルス感染症COVID-19診療の手引き 第5版［Internet］．厚生労働省；［updated 2021 May 16; cited 2021 May 26］．Available from: https://www.mhlw.go.jp/content/000785013.pdf 20) Centers for Disease Control and Prevention (US). Discontinuation of transmission-based precautions and disposition of patients with SARS-CoV-2 infection in healthcare settings [Internet]. U.S. [updated 2020 August 10; cited 2021 June 2]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html 7) Collaborative C, Collaborative G. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021;76(6):748–758. 14) Al-Batran SE, Homann N, Pauligk C, Goetze TO, Meiler J, Kasper S, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393(10184):1948–1957. 4) El-Boghdadly K, Cook TM, Goodacre T, Kua J, Blake L, Denmark S, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: a multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia. 2021;76(7):940–946. 17) Tokunaga M, Sato Y, Nakagawa M, Aburatani T, Matsuyama T, Nakajima Y, et al. Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives. Surg Today. 2020;50(1):30–37. 1) Liu C, Zhao Y, Okwan-Duodu D, Basho R, Cui X. COVID-19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020;17(3):519–527. 10) Nepogodiev D, Omar OM, Glasbey JC, Li E, Simoes JFF, Abbott TEF, et al. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107(11):1440–1449. 12) Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, et al. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol. 2012;23(10):2731–2737. 2) Richards M, Anderson M, Carter P, Ebert BL, Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nat Cancer. 2020;1(6):565–567. 11) Fujiya K, Irino T, Furukawa K, Omori H, Makuuchi R, Tanizawa Y, et al. Safety of prolonged wait time for gastrectomy in clinical stage I gastric cancer. Eur J Surg Oncol. 2019;45(10):1964–1968. 16) Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (ver. 5). Gastric Cancer. 2018;46(3):20–31. 8) Finley C, Prashad A, Camuso N, Daly C, Aprikian A, Ball CG, et al. Guidance for management of cancer surgery during the COVID-19 pandemic. Can J Surg. 2020;63(22):S2–S4. 19) Rhee C, Kanjilal S, Baker M, Klompas M. Duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity: when is it safe to discontinue isolation? Clin Infect Dis. 2021;72(8):1467–1474. 6) Senent-Boza A, Benítez-Linero I, Tallón-Aguilar L, Sánchez-Arteaga A, Melero-Cortés L, Pareja-Ciuró F, et al. Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic. Surg Today. 2020;50(9):1107–1112. 3) Covid-19感染既往患者の待機手術再開時期に関する提言［Internet］．日本麻酔科学会；［cited 2021 March 18］．Available from: https://anesth.or.jp/img/upload/ckeditor/files/COVID-19感染既往患者の待機手術再開時期に関する提言.pdf 23) Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, et al. Safe management of surgical smoke in the age of COVID-19. Br J Surg. 2020;107(11):1406–1413. 24) Lee T, Soo JC, LeBouf RF, Burns D, Berry DS, Kashon M, et al. Surgical smoke control with local exhaust ventilation: Experimental study. J Occup Environ Hyg. 2018;15:341–350. 15) Kang WZ, Zhong YX, Ma FH, Liu H, Ma S, Li Y, et al. Treatment strategies for gastric cancer during the COVID-19 pandemic. World J Clin Cases. 2020;8(21):5099–5103. 21) World Health Organization. Clinical management of COVID‐19 [Internet]. WHO Guideline Development Group for Clinical Management of COVID-19. [updated 2020 May 18]. Available from: https://www.who.int/teams/health-care-readiness-clinical-unit/covid-19 9) Ji C, Singh K, Luther AZ, Agrawal A. Is elective cancer surgery safe during the COVID-19 pandemic? World J Surg. 2020;44(10):3207–3211. 13) Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJH, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20. |
| References_xml | – reference: 11) Fujiya K, Irino T, Furukawa K, Omori H, Makuuchi R, Tanizawa Y, et al. Safety of prolonged wait time for gastrectomy in clinical stage I gastric cancer. Eur J Surg Oncol. 2019;45(10):1964–1968. – reference: 5) 新型コロナウイルス感染症COVID-19診療の手引き 第5版［Internet］．厚生労働省；［updated 2021 May 16; cited 2021 May 26］．Available from: https://www.mhlw.go.jp/content/000785013.pdf – reference: 13) Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJH, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20. – reference: 24) Lee T, Soo JC, LeBouf RF, Burns D, Berry DS, Kashon M, et al. Surgical smoke control with local exhaust ventilation: Experimental study. J Occup Environ Hyg. 2018;15:341–350. – reference: 10) Nepogodiev D, Omar OM, Glasbey JC, Li E, Simoes JFF, Abbott TEF, et al. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107(11):1440–1449. – reference: 19) Rhee C, Kanjilal S, Baker M, Klompas M. Duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity: when is it safe to discontinue isolation? Clin Infect Dis. 2021;72(8):1467–1474. – reference: 3) Covid-19感染既往患者の待機手術再開時期に関する提言［Internet］．日本麻酔科学会；［cited 2021 March 18］．Available from: https://anesth.or.jp/img/upload/ckeditor/files/COVID-19感染既往患者の待機手術再開時期に関する提言.pdf – reference: 2) Richards M, Anderson M, Carter P, Ebert BL, Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nat Cancer. 2020;1(6):565–567. – reference: 23) Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, et al. Safe management of surgical smoke in the age of COVID-19. Br J Surg. 2020;107(11):1406–1413. – reference: 6) Senent-Boza A, Benítez-Linero I, Tallón-Aguilar L, Sánchez-Arteaga A, Melero-Cortés L, Pareja-Ciuró F, et al. Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic. Surg Today. 2020;50(9):1107–1112. – reference: 4) El-Boghdadly K, Cook TM, Goodacre T, Kua J, Blake L, Denmark S, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: a multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia. 2021;76(7):940–946. – reference: 17) Tokunaga M, Sato Y, Nakagawa M, Aburatani T, Matsuyama T, Nakajima Y, et al. Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives. Surg Today. 2020;50(1):30–37. – reference: 21) World Health Organization. Clinical management of COVID‐19 [Internet]. WHO Guideline Development Group for Clinical Management of COVID-19. [updated 2020 May 18]. Available from: https://www.who.int/teams/health-care-readiness-clinical-unit/covid-19 – reference: 16) Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (ver. 5). Gastric Cancer. 2018;46(3):20–31. – reference: 8) Finley C, Prashad A, Camuso N, Daly C, Aprikian A, Ball CG, et al. Guidance for management of cancer surgery during the COVID-19 pandemic. Can J Surg. 2020;63(22):S2–S4. – reference: 12) Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, et al. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol. 2012;23(10):2731–2737. – reference: 18) Terashima M, Yoshikawa T, Boku N, Ito S, Tsuburaya A, Iwasaki Y, et al. Current status of perioperative chemotherapy for locally advanced gastric cancer and JCOG perspectives. Jpn J Clin Oncol. 2020;50(5):528–534. – reference: 7) Collaborative C, Collaborative G. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021;76(6):748–758. – reference: 20) Centers for Disease Control and Prevention (US). Discontinuation of transmission-based precautions and disposition of patients with SARS-CoV-2 infection in healthcare settings [Internet]. U.S. [updated 2020 August 10; cited 2021 June 2]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html – reference: 14) Al-Batran SE, Homann N, Pauligk C, Goetze TO, Meiler J, Kasper S, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393(10184):1948–1957. – reference: 22) European Centre for Disease Prevention and control (ECDC). Guidance for discharge and ending of isolation of people with COVID-19 [Internet]. European Union. [updated 2020 October 16]. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Guidance-for-discharge-and-ending-of-isolation-of-people-with-COVID-19.pdf – reference: 15) Kang WZ, Zhong YX, Ma FH, Liu H, Ma S, Li Y, et al. Treatment strategies for gastric cancer during the COVID-19 pandemic. World J Clin Cases. 2020;8(21):5099–5103. – reference: 1) Liu C, Zhao Y, Okwan-Duodu D, Basho R, Cui X. COVID-19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020;17(3):519–527. – reference: 9) Ji C, Singh K, Luther AZ, Agrawal A. Is elective cancer surgery safe during the COVID-19 pandemic? World J Surg. 2020;44(10):3207–3211. |
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