|
1
|
Jagdewsing DR, Fahmy NSC, Chen X, Keuzetien YK, Silva FA, Kang H, Xu Y, Al-Sharabi A, Jagdewsing SA, Jagdewsing SA. Postoperative Surgical Site and Secondary Infections in Colorectal Cancer Patients With a History of SARS-CoV-2: A Retrospective Cohort Study. Cureus 2025; 17:e78077. [PMID: 40013200 PMCID: PMC11864455 DOI: 10.7759/cureus.78077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic brought unique challenges to the field of healthcare, particularly to the surgical field. This retrospective cohort study aims to compare the risk of surgical site infection (SSI) and secondary infection between colorectal cancer (CRC) patients with a history of COVID-19 infection and those without. METHOD A cohort of 200 CRC patients, comprising 100 with a documented history of COVID-19 infection and 100 without, were retrospectively analyzed. Independent sample t-tests for continuous variables, Chi-square tests for categorical variables, and additionally univariate and multivariate binary logistic regression analysis were performed using IBM SPSS Statistics for Windows, Version 29.0.2 (Released 2023; IBM Corp., Armonk, New York, United States). The data were collected from the medical records of patients treated at the Hernia and Colorectal Surgery department of the Second Affiliated Hospital of Dalian Medical University, Dalian, China. Key clinical variables examined included the incidence of SSIs, occurrence of secondary infections, presence of comorbidities such as diabetes and hypertension, and duration of hospitalization. RESULTS The comparative analysis yielded compelling differences between CRC patients with a history of COVID-19 infection and those without. The study revealed a significantly higher incidence of SSI (68.8% vs. 31.3%, p=0.003) and secondary infection (70.1% vs. 29.9%, p<0.001) among patients with a history of COVID-19. In the multivariate analysis for SSIs, hypertension (OR = 2.78, 95%CI: 1.03-7.54, p=0.044) and surgical procedure type (open vs. laparoscopic) (OR = 6.04, 95%CI: 1.88-19.43, p=0.003) were found to be significant independent predictors. Patients with a history of COVID-19 had a significantly higher incidence of secondary infections (70.1% vs. 29.9%, p<0.001), with multivariate analysis showing COVID-19 status (OR: 3.053, 95%CI: 1.515-6.154, p=0.002), hypertension (OR: 2.632, 95% CI: 1.154-6.006, p=0.021), and diabetes mellitus (OR: 4.326, 95%CI: 2.029-9.226, p<0.001) as independent risk factors. CONCLUSION This study highlights significant insight into SSI rates, secondary infection rates, and clinical characteristics between CRC patients with and without a history of COVID-19 infection. The findings underscore that CRC patients with hypertension who underwent open surgery procedures exhibited a higher susceptibility to SSI. Following CRC patients in combination with comorbidities such as hypertension, diabetes, and a history of COVID-19 infection exhibited higher susceptibility to secondary infections. This study contributes to the evolving understanding of the impact of COVID-19 history on surgical outcomes, providing valuable insight to healthcare providers in optimizing care for CRC patients in the context of this ongoing health crisis.
Collapse
Affiliation(s)
- Dhierin R Jagdewsing
- Department of Hernia and Colorectal Cancer, Second Affiliated Hospital of Dalian Medical University, Dalian, CHN
| | | | - Xin Chen
- Department of Hernia and Colorectal Cancer, Second Affiliated Hospital of Dalian Medical University, Dalian, CHN
| | - Yanick K Keuzetien
- Department of Spine Surgery, Southern Medical University, Guangzhou, CHN
| | | | - Haonan Kang
- Department of Hernia and Colorectal Cancer, Second Affiliated Hospital of Dalian Medical University, Dalian, CHN
| | - Yang Xu
- Department of Hernia and Colorectal Cancer, Second Affiliated Hospital of Dalian Medical University, Dalian, CHN
| | - Abdulkarem Al-Sharabi
- Department of Hernia and Colorectal Cancer, Second Affiliated Hospital of Dalian Medical University, Dalian, CHN
| | | | | |
Collapse
|
|
2
|
Cao L, Chen F, Xu L, Zeng J, Wang Y, Zhang S, Ba Y, Zhang H. Prognostic cellular senescence-related lncRNAs patterns to predict clinical outcome and immune response in colon cancer. Front Immunol 2024; 15:1450135. [PMID: 39355236 PMCID: PMC11443174 DOI: 10.3389/fimmu.2024.1450135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/19/2024] [Indexed: 10/03/2024] Open
Abstract
Background Cellular senescence (CS) is believed to be a major factor in the evolution of cancer. However, CS-related lncRNAs (CSRLs) involved in colon cancer regulation are not fully understood. Our goal was to create a novel CSRLs prognostic model for predicting prognosis and immunotherapy and exploring its potential molecular function in colon cancer. Methods The mRNA sequencing data and relevant clinical information of GDC TCGA Colon Cancer (TCGA-COAD) were obtained from UCSC Xena platform, and CS-associated genes was acquired from the CellAge website. Pearson correlation analysis was used to identify CSRLs. Then we used Kaplan-Meier survival curve analysis and univariate Cox analysis to acquire prognostic CSRL. Next, we created a CSRLs prognostic model using LASSO and multivariate Cox analysis, and evaluated its prognostic power by Kaplan-Meier and ROC curve analysis. Besides, we explored the difference in tumor microenvironment, somatic mutation, immunotherapy, and drug sensitivity between high-risk and low-risk groups. Finally, we verified the functions of MYOSLID in cell experiments. Results Three CSRLs (AC025165.1, LINC02257 and MYOSLID) were identified as prognostic CSRLs. The prognostic model exhibited a powerful predictive ability for overall survival and clinicopathological features in colon cancer. Moreover, there was a significant difference in the proportion of immune cells and the expression of immunosuppressive point biomarkers between the different groups. The high-risk group benefited from the chemotherapy drugs, such as Teniposide and Mitoxantrone. Finally, cell proliferation and CS were suppressed after MYOSLID knockdown. Conclusion CSRLs are promising biomarkers to forecast survival and therapeutic responses in colon cancer patients. Furthermore, MYOSLID, one of 3-CSRLs in the prognostic model, could dramatically regulate the proliferation and CS of colon cancer.
Collapse
Affiliation(s)
- Lichao Cao
- Shenzhen Nucleus Gene Technology Co., Ltd., Shenzhen, Guangdong, China
- Shenzhen Nucleus Huaxi Medical Laboratory, Shenzhen, Guangdong, China
- Shanghai Nucleus Biotechnology Co., Ltd., Shanghai, China
| | - Fang Chen
- Shenzhen Nucleus Gene Technology Co., Ltd., Shenzhen, Guangdong, China
- Shenzhen Nucleus Huaxi Medical Laboratory, Shenzhen, Guangdong, China
- Shanghai Nucleus Biotechnology Co., Ltd., Shanghai, China
| | - Long Xu
- Department of Gastroenterology and Hepatology, Shenzhen University General Hospital, Shenzhen, Guangdong, China
- Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, Guangdong, China
| | - Jian Zeng
- Longhua Innovation Institute for Biotechnology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, China
| | - Yun Wang
- Longhua Innovation Institute for Biotechnology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, China
| | - Shenrui Zhang
- Shenzhen Nucleus Gene Technology Co., Ltd., Shenzhen, Guangdong, China
- Shenzhen Nucleus Huaxi Medical Laboratory, Shenzhen, Guangdong, China
- Shanghai Nucleus Biotechnology Co., Ltd., Shanghai, China
| | - Ying Ba
- Shenzhen Nucleus Gene Technology Co., Ltd., Shenzhen, Guangdong, China
- Shenzhen Nucleus Huaxi Medical Laboratory, Shenzhen, Guangdong, China
- Shanghai Nucleus Biotechnology Co., Ltd., Shanghai, China
| | - Hezi Zhang
- Shenzhen Nucleus Gene Technology Co., Ltd., Shenzhen, Guangdong, China
- Shenzhen Nucleus Huaxi Medical Laboratory, Shenzhen, Guangdong, China
- Shanghai Nucleus Biotechnology Co., Ltd., Shanghai, China
| |
Collapse
|
|
3
|
Liu X, Liu T, Wan R. Clinical presentation of severe COVID‑19 with heart failure: A single‑center retrospective study. Exp Ther Med 2024; 27:193. [PMID: 38590575 PMCID: PMC11000051 DOI: 10.3892/etm.2024.12481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/09/2024] [Indexed: 04/10/2024] Open
Abstract
The coronavirus disease-19 (COVID-19) pandemic has led to a global transformation in public health interventions. The present study aimed to evaluate the clinical features as well as the outcomes of severe heart failure (HF) among patients with severe COVID-19. A single-center observational study was carried out at The 904th Hospital of Joint Logistic Support Force (Wuxi, China) from November 2022 to April 2023, and a total of 210 patients diagnosed with severe HF were included. Among these patients, 128 patients had COVID-19 whereas the remaining patients were not diagnosed with COVID-19. The analysis entailed investigated pre-existing medical records, that is, admission and discharge, laboratory values, neuroimaging, length of hospitalization, mortality and costs incurred by patients throughout the COVID-19 pandemic from the records. All the 210 incorporated patients accomplished the follow-up and it was established that there was no significant differences in baseline characteristics between HF combined with COVID-19 and HF without COVID-19 were affirmed (P>0.05). HF coupled with COVID-19 infection demonstrated an increased risk of 30-day mortality (28.91 vs. 14.63%; P=0.017), extended length of hospital stays (22.54±6.73 vs. 19.35±5.69; P<0.001) and higher expenses for hospitalization (P<0.001). Complications related to hospitalization, including pneumonia (76.56 vs. 35.37%; P=1.0x10-4), respiratory failure (47.66 vs. 24.39%; P=0.001), pulmonary embolism (8.59 vs. 2.44%; P=0.031), deep vein thrombosis (30.47 vs. 14.63%; P=0.009), 7 days delirium (60.16 vs. 45.12%; P=0.033), multiple organ dysfunction syndrome (32.81 vs. 18.29%; P=0.021) and neurological deficits (30.47% vs. 17.07%, P=0.029) increased significantly. In conclusion, HF combined with COVID-19, treatment and prognosis are getting worse. Enhancing preparedness for future COVID-19 and other similar pandemics necessitates the comprehension of this to refine care provided to patients with HF (registration no. THH-IPR-20221101 on 01 November 2022).
Collapse
Affiliation(s)
- Xinling Liu
- Department of Quality Management, The 904th Hospital of Joint Logistic Support Force (Wuxi Taihu Hospital), Wuxi, Jiangsu 214044, P.R. China
| | - Tingting Liu
- Department of Quality Management, The 904th Hospital of Joint Logistic Support Force (Wuxi Taihu Hospital), Wuxi, Jiangsu 214044, P.R. China
| | - Rong Wan
- Department of Quality Management, The 904th Hospital of Joint Logistic Support Force (Wuxi Taihu Hospital), Wuxi, Jiangsu 214044, P.R. China
| |
Collapse
|
|
4
|
Filip F, Avramia R, Terteliu-Baitan M, Cocuz ME, Filip R. COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics. Medicine (Baltimore) 2023; 102:e36235. [PMID: 38050253 PMCID: PMC10695600 DOI: 10.1097/md.0000000000036235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/30/2023] [Indexed: 12/06/2023] Open
Abstract
RATIONALE The COVID-19 pandemic had a dramatic effect on various health systems in terms of admissions and outcomes, including pediatric surgery activity. The aim of this paper was to analyze the outcome of SARS-CoV-2-positive patients admitted to our department during the regional COVID-19 pandemic in North-Eastern Romania. We also evaluated the changes generated in our daily practice by the COVID-19 pandemic and the dynamic response to this major challenge. PATIENT CONCERNS The patients presented with symptoms related to their primary diagnosis: local pain and deformity in case of fractures; pain, swelling, and erythema in case of abscess; pain and decreased range of motion (ROM) in case of intolerance to metal implants. Other specific concerns are mentioned on an individual basis. DIAGNOSES Eighteen patients (of which 4 had acute appendicitis and were included in a previous article), representing 1.18% of the total number of admissions, tested positive for SARS-CoV-2. There were 4 patients with fractures, 3 patients with soft tissue abscess or cellulitis, 2 patients with intolerance to metal implants, 1 patient with facial burn, 1 patient with thumb laceration, 1 patient with liver trauma, 1 patient with undescende testis, and 1 patient with symptomatic inguinal hernia, respectively. Boys represented 11/ 14 (78.57%) of the cases. The mean age of the patients was 9 years 11 months. There were only mild COVID-19 cases. INTERVENTIONS Surgery was performed in 13/ 14 (95.71%) of cases. The fractures were treated with open reduction internal fixation (ORIF); incision and drainage (I & D) were performed in case of soft tissue abscess; the metal implants were removed in case of local intolerance. Other conditions (burn, inguinal hernia, undescended testis, skin laceration) were treated specifically. Only 1 patient with liver laceration was treated conservatively under close hemodynamic monitoring. OUTCOMES The mean length of stay (LoS) was 2.71 days. The infection with the SARS-CoV-2 virus had no deleterious effect on the surgical outcome among the 14 patients included in the study. There were no surgical complications during admission and no patient returned for late complications related to their primary disease or SARS-CoV-2 infection. LESSONS The SARS-CoV-2 infection had no significant influence on the outcome of pediatric surgical cases included in the study. We noticed a significant (31.54%) decrease in the number of admissions compared to the previous 2-year interval before the COVID-19 pandemic. Fast and adequate adjustment of the daily activity imposed by the COVID-19 pandemic was feasible and may be used in the future should similar epidemiological emergencies occur.
Collapse
Affiliation(s)
- Florin Filip
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, Suceava, Romania
- Suceava Emergency County Hospital, Suceava, Romania
| | | | - Monica Terteliu-Baitan
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, Suceava, Romania
- Suceava Emergency County Hospital, Suceava, Romania
| | - Maria - Elena Cocuz
- Fundamental Prophylactic and Clinical Disciplines Department, Faculty of Medicine, Transilvania University of Brasov, Brașov, Romania
- Clinical Infectious Diseases Hospital of Brasov, Brasov, Romania
| | - Roxana Filip
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, Suceava, Romania
- Suceava Emergency County Hospital, Suceava, Romania
| |
Collapse
|
|
5
|
Feier CVI, Santoro RR, Faur AM, Muntean C, Olariu S. Assessing Changes in Colon Cancer Care during the COVID-19 Pandemic: A Four-Year Analysis at a Romanian University Hospital. J Clin Med 2023; 12:6558. [PMID: 37892695 PMCID: PMC10607165 DOI: 10.3390/jcm12206558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
This retrospective study investigates the impact of the COVID-19 pandemic on the surgical management of patients with colon cancer in a tertiary University Hospital in Timisoara, Romania. Data from 867 patients who underwent surgical interventions for this condition between 26 February 2019 and 25 February 2023 were meticulously analyzed to evaluate substantial shifts in the management and outcomes of these patients in comparison to the pre-pandemic era. The results reveal a substantial decrease in elective surgical procedures (p < 0.001) and a significant increase in emergency interventions (p < 0.001). However, postoperative mortality did not show significant variations. Of concern is the diagnosis of patients at more advanced stages of colon cancer, with a significant increase in Stage IV cases in the second year of the pandemic (p = 0.045). Average hospitalization durations recorded a significant decrease (p < 0.001) during the pandemic, and an inverse correlation between patient age and surgery duration was reported (p = 0.01, r = -0.088). This analysis provides a comprehensive perspective on how the pandemic has influenced the management of colon cancer, highlighting significant implications for the management and outcomes of these patients.
Collapse
Affiliation(s)
- Catalin Vladut Ionut Feier
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Rebecca Rosa Santoro
- Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alaviana Monique Faur
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Calin Muntean
- Medical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania
| | - Sorin Olariu
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| |
Collapse
|
|
6
|
Effects of the COVID-19 pandemic on colorectal cancer surgery. JOURNAL OF SURGERY AND MEDICINE 2023. [DOI: 10.28982/josam.7739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Background/Aim: In accordance with the guidelines published during the COVID-19 pandemic, cancer operations, except for emergencies, were postponed. However, the effect of postponed surgical treatment on the outcomes of cancer cases has not yet been determined. Therefore, this study aimed to compare the clinical data and outcomes of patients who underwent surgery for colorectal cancer before and during the pandemic.
Methods: This retrospective cohort study was conducted in the Department of General Surgery. Patients who underwent surgery for colorectal cancer during the pre-pandemic period (February 1, 2019-December 31, 2019) and pandemic period (August 1, 2020-June 30, 2021) were included. The patients’ demographic data, clinical and laboratory findings, clinical presentation, operation type, complications, and pathology results were retrospectively obtained by screening the patient files.
Results: The study included a total of 183 patients, 91 in the pre-pandemic period and 92 in the pandemic period. During the pandemic period, the length of hospital stay was significantly shorter, but the rate of readmission after discharge was significantly higher (P<0.001, P=0.04). There was no significant difference between the two periods in terms of disease stage. During the pandemic period, the number of cases that underwent emergency surgery was significantly higher. The rates of mortality and postoperative complication rates were also significantly higher (P=0.04, P<0.001).
Conclusion: The pandemic had serious effects on colorectal cancer cases. There was an increase in mortality and morbidity due to the increase in complicated cases.
Collapse
|
|
7
|
Chen SY, Radomski SN, Stem M, Papanikolaou A, Gabre-Kidan A, Atallah C, Efron JE, Safar B. Colorectal Surgery Outcomes in the United States During the COVID-19 Pandemic. J Surg Res 2023; 287:95-106. [PMID: 36893610 PMCID: PMC9868386 DOI: 10.1016/j.jss.2022.12.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/02/2022] [Accepted: 12/25/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The purpose of this study was to assess colorectal surgery outcomes, discharge destination, and readmission in the United States during the COVID-19 pandemic. METHODS Adult colorectal surgery patients in the American College of Surgeons National Surgical Quality Improvement Program database (2019-2020) and its colectomy and proctectomy procedure-targeted files were included. The prepandemic time period was defined from April 1, 2019 to December 31, 2019. The pandemic time period was defined from April 1, 2020 to December 31, 2020 in quarterly intervals (Q2 April-June; Q3 July-September; Q4 October-December). Factors associated with morbidity and in-hospital mortality were assessed using multivariable logistic regression. RESULTS Among 62,393 patients, 34,810 patients (55.8%) underwent colorectal surgery prepandemic and 27,583 (44.2%) during the pandemic. Patients who had surgery during the pandemic had higher American Society of Anesthesiologists class and presented more frequently with dependent functional status. The proportion of emergent surgeries increased (12.7% prepandemic versus 15.2% pandemic, P < 0.001), with less laparoscopic cases (54.0% versus 51.0%, P < 0.001). Higher rates of morbidity with a greater proportion of discharges to home and lesser proportion of discharges to skilled care facilities were observed with no considerable differences in length of stay or worsening readmission rates. Multivariable analysis demonstrated increased odds of overall and serious morbidity and in-hospital mortality, during Q3 and/or Q4 of the 2020 pandemic. CONCLUSIONS Differences in hospital presentation, inpatient care, and discharge disposition of colorectal surgery patients were observed during the COVID-19 pandemic. Pandemic responses should emphasize balancing resource allocation, educating patients and providers on timely medical workup and management, and optimizing discharge coordination pathways.
Collapse
Affiliation(s)
- Sophia Y Chen
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Shannon N Radomski
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Miloslawa Stem
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Angelos Papanikolaou
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Alodia Gabre-Kidan
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Chady Atallah
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland; Department of Surgery, NYU Langone Health, New York, New York
| | - Jonathan E Efron
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland
| | - Bashar Safar
- Department of Surgery, The Johns Hopkins University School of Medicine, Colorectal Research Unit, Baltimore, Maryland; Department of Surgery, NYU Langone Health, New York, New York.
| |
Collapse
|
|
8
|
Dimovska M, Borota-Popovska M, Topuzovska-Latkovikj M, Pavleska-Kuzmanoska S. Some Aspects of Women’s Health in Republic of Macedonia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION: Sex and gender "matters" in terms of the health status as well as a result of both biological and gender-related differences.
AIM: To analyze sex and gender-based differences in North Macedonia through analysis of some aspects of mortality, the knowledge and attitudes related to women’s health.
METHODS: Analysis of the general and age-standardized mortality patterns and CAPI (Computer-assisted personal interview) composed on different topics including women's health for the period 2017-2020 were used.
RESULTS: Age-standardized mortality rates (all-causes of death, circulatory and respiratory diseases and neoplasms) are prevalent and higher in the male population in North Macedonia. A significantly higher all-cause mortality trend for both sexes was found in 2020 making this year hardly comparable with the previous years. A decreasing trend of malignant neoplasms rate of female genital organs and an increasing trend of breast cancer mortality is observed.
The majority of the respondents (50.6%) rated their current health status as excellent with a statistically significant difference between the age and ethnical groups. One-third of the respondents reported regular physical activity, mostly on a daily basis. The majority (39.3%) are overweight and 27.5% belongs to the obesity class I without a significant difference in terms of ethnicity.
Respondents (27%), reported that have high blood pressure, 20.2% vaginal infections, 19.9% allergies, heart issues 15.1%, anemia 11.7%, while diabetes and cancer 8.5% and 2.5% respectively. The youngest and oldest age group of Albanian women are the least informed about the early detection procedures of malignant compared to Macedonian women and other ethnic groups.
CONCLUSIONS: Analyzing some aspects of women's health in North Macedonia through the mortality, knowledge and attitudes of Macedonian women, we provide some further evidence for the development and implementation of targeted interventions and policies aimed to reduce the sex and gender-based health inequalities in the country.
Collapse
|
|
9
|
Akbulut S, Hargura AS, Garzali IU, Aloun A, Colak C. Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic. World J Clin Cases 2022; 10:9228-9240. [PMID: 36159422 PMCID: PMC9477669 DOI: 10.12998/wjcc.v10.i26.9228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/29/2022] [Accepted: 08/06/2022] [Indexed: 02/05/2023] Open
Abstract
Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.
Collapse
Affiliation(s)
- Sami Akbulut
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Abdirahman Sakulen Hargura
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Kenyatta University Teaching, Referral and Research Hospital, Nairobi 00100, Kenya
| | - Ibrahim Umar Garzali
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Aminu Kano Teaching Hospital, Kano 700101, Nigeria
| | - Ali Aloun
- Department of Surgery, King Hussein Medical Center, Amman 11855, Jordan
| | - Cemil Colak
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| |
Collapse
|
|
10
|
Eklöv K, Nygren J, Bringman S, Löfgren J, Sjövall A, Nordenvall C, Everhov ÅH. Colon cancer treatment in Sweden during the COVID-19 pandemic: A nationwide register-based study. Colorectal Dis 2022; 24:925-932. [PMID: 35362199 PMCID: PMC9111816 DOI: 10.1111/codi.16129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 02/08/2023]
Abstract
AIM The COVID-19 pandemic has reduced the capacity to diagnose and treat cancer worldwide due to the prioritization of COVID-19 treatment. The aim of this study was to investigate treatment and outcomes of colon cancer in Sweden before and during the COVID-19 pandemic. METHODS In an observational study, using the Swedish Colorectal Cancer Registry, we included (i) all Swedish patients diagnosed with colon cancer, and (ii) all patients undergoing surgery for colon cancer, in 2016-2020. Incidence of colon cancer, treatments and outcomes in 2020 were compared with 2019. RESULTS The number of colon cancer cases in Sweden in April-May 2020 was 27% lower than the previous year, whereas no difference was observed on an annual level (4,589 vs. 4,763 patients [-4%]). Among patients with colon cancer undergoing surgery in 2020, the proportion of resections was 93 vs. 94% in 2019, with no increase in acute resections. Time from diagnosis to elective surgery decreased (29 days vs. 33 days in 2020 vs. 2019). In 2020, more patients underwent a two-stage procedure with a diverting stoma as first surgery (6.1%) vs. (4.4%) in 2019 (p = 0.0020) and more patients were treated with preoperative chemotherapy (5.1%) vs. (3,5%) 2019 (p = 0.0016). The proportion of patients that underwent laparoscopic surgery increased from 54% to 58% (p = 0.0017) There were no differences in length of stay, surgical complications, reoperation, ICU-stay or 30-day mortality between the years. CONCLUSION Based on nationwide annual data, we did not observe adverse effects of the COVID-19 pandemic on colon cancer treatment and short time outcomes in Sweden.
Collapse
Affiliation(s)
- Karolina Eklöv
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Jonas Nygren
- Department of SurgeryErsta HospitalStockholmSweden,Department of Clinical SciencesDanderyd Hospital, Karolinska InstitutetStockholmSweden
| | - Sven Bringman
- Department of SurgerySödertälje HospitalStockholmSweden,Department of Clinical Science and EducationSödersjukhuset Hospital, Karolinska InstitutetStockholmSweden
| | - Jenny Löfgren
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Annika Sjövall
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden,Colorectal Surgery Unit, Department of Pelvic CancerKarolinska University HospitalStockholmSweden
| | - Caroline Nordenvall
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden,Colorectal Surgery Unit, Department of Pelvic CancerKarolinska University HospitalStockholmSweden
| | - Åsa H. Everhov
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden,Clinical Epidemiology Unit, Department of Medicine SolnaKarolinska InstitutetStockholmSweden
| |
Collapse
|
|
11
|
Tang Y, Liu J, Huang X, Ding H, Tan S, Zhu Y. Effect of Dexmedetomidine-Assisted Intravenous Inhalation Combined Anesthesia on Cerebral Oxygen Metabolism and Serum Th1/Th2 Level in Elderly Colorectal Cancer Patients. Front Surg 2022; 8:832646. [PMID: 35145993 PMCID: PMC8821817 DOI: 10.3389/fsurg.2021.832646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/24/2021] [Indexed: 11/14/2022] Open
Abstract
Objective To observe the effect of dexmedetomidine-assisted intravenous inhalation combined anesthesia on cerebral oxygen metabolism and serum Th1/Th2 levels in elderly patients with colorectal cancer. Method From April 2018 to May 2020,100 elderly patients undergoing elective laparoscopic radical resection of colorectal cancer were prospectively selected and randomly divided into observation group and control group. Before induction of anesthesia, the loading dose of dexmedetomidine was given at 0.5 μg/kg, and the infusion time was 15 min. After tracheal intubation, 0.4 μg/kg/h dexmedetomidine was continuously pumped, and the infusion was stopped 40 min before the end of the operation. In the control group, the same amount of 0.9% sodium chloride was injected intravenously in the same way. 30 min before induction of anesthesia (T0), immediately before induction of anesthesia (T1), immediately after tracheal intubation (T2), 40 min before operation (T3), and immediately after operation (T4), record the blood oxygen content of the artery and internal jugular vein Difference (D(a-jv)O2), brain oxygen uptake rate (COER%), brain oxygen saturation (rSO2) mean. VAS scale, Ramsay scale, MoCA scale were taken at 6, 12, 24, and 48 h postoperatively to evaluate analgesia, sedation, and cognitive function. And monitor the levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), myelin basic protein (MBP), neuron-specific enolase (NSE) and S100β. The occurrence of restlessness and adverse reactions during the recovery period of the two groups were compared. Result The levels of D(a-jv)O2, COER%, and rSO2 in the control group and observation group were higher than the preoperative basic values at T2, T3, and T4 (P < 0.05); The levels of D(a-jv)O2, COER%, and rSO2 in the observation group were lower than those in the control group at T2, T3, and T4 (P < 0.05). The VAS score and Ramsay score of the observation group were lower than those of the control group at 6, 12, 24, and 48 h after surgery, while the MoCA score was higher than that of the control group (P < 0.05). In addition, the serum IFN-γ, MBP, NSE and S100β levels of the observation group were lower than those of the control group (P < 0.05), and the ratio of IFN-γ/IL-4 was higher than that of the control group (P < 0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group [32.0% (16/50) vs. 12.0% (6/50), P < 0.05]. Conclusion Dexmedetomidine-assisted combined intravenous and inhalation anesthesia is beneficial to reduce perioperative cerebral oxygen metabolism and improve postoperative immunosuppression in elderly patients with colorectal cancer. It has a certain protective effect on nerve injury after operation, thus improving the cognitive function of patients and reducing the occurrence of adverse reactions.
Collapse
Affiliation(s)
- Yixun Tang
- Department of Anesthesiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- School of Life Sciences, Hunan Normal University, Changsha, China
- Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China
| | - Jitong Liu
- Department of Anesthesiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China
| | - Xiaoling Huang
- Department of Anesthesiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China
| | - Huijuan Ding
- Department of Anesthesiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China
| | - Suhong Tan
- Department of Anesthesiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China
| | - Yimin Zhu
- School of Life Sciences, Hunan Normal University, Changsha, China
- Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Institute of Emergency Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Yimin Zhu
| |
Collapse
|
|
12
|
Qin J, Guo C, Yang L, Liang X, Jiao A, Lai KP, Yang B. Bioinformatics and in-silico findings reveal medical features and pharmacological targets of biochanin A against colorectal cancer and COVID-19. Bioengineered 2021; 12:12461-12469. [PMID: 34931923 PMCID: PMC8809988 DOI: 10.1080/21655979.2021.2005876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Severe mortality due to the COVID-19 pandemic resulted from the lack of effective treatment. Although COVID-19 vaccines are available, their side effects have become a challenge for clinical use in patients with chronic diseases, especially cancer patients. In the current report, we applied network pharmacology and systematic bioinformatics to explore the use of biochanin A in patients with colorectal cancer (CRC) and COVID-19 infection. Using the network pharmacology approach, we identified two clusters of genes involved in immune response (IL1A, IL2, and IL6R) and cell proliferation (CCND1, PPARG, and EGFR) mediated by biochanin A in CRC/COVID-19 condition. The functional analysis of these two gene clusters further illustrated the effects of biochanin A on interleukin-6 production and cytokine-cytokine receptor interaction in CRC/COVID-19 pathology. In addition, pathway analysis demonstrated the control of PI3K-Akt and JAK-STAT signaling pathways by biochanin A in the treatment of CRC/COVID-19. The findings of this study provide a therapeutic option for combination therapy against COVID-19 infection in CRC patients.
Collapse
Affiliation(s)
- Jingru Qin
- College of Pharmacy, Guangxi Medical University, Nanning, Guangxi, PR China
| | - Chao Guo
- Department of Pharmacy, Guigang City People's Hospital, the Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi, PR China
| | - Lu Yang
- Laboratory of Environmental Pollution and Integrative Omics, Guilin Medical University, Guilin, PR China
| | - Xiao Liang
- College of Pharmacy, Guangxi Medical University, Nanning, Guangxi, PR China
| | - Aijun Jiao
- College of Pharmacy, Guangxi Medical University, Nanning, Guangxi, PR China
| | - Keng Po Lai
- Laboratory of Environmental Pollution and Integrative Omics, Guilin Medical University, Guilin, PR China
| | - Bin Yang
- College of Pharmacy, Guangxi Medical University, Nanning, Guangxi, PR China
| |
Collapse
|
|
13
|
Xia F, Yan Y, Shen C. A Prognostic Pyroptosis-Related lncRNAs Risk Model Correlates With the Immune Microenvironment in Colon Adenocarcinoma. Front Cell Dev Biol 2021; 9:811734. [PMID: 34966747 PMCID: PMC8710686 DOI: 10.3389/fcell.2021.811734] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 02/05/2023] Open
Abstract
Recent studies have indicated that long non-coding RNAs (lncRNAs) may participate in the regulation of tumor cell proptosis. However, the connection between lncRNA expression and pyroptosis remains unclear in colon adenocarcinoma (COAD). This study aims to explore and establish a prognostic signature of COAD based on the pyroptosis-related lncRNAs. We identify 15 prognostic pyroptosis-related lncRNAs (ZNF667-AS1, OIP5-AS1, AL118506.1, AF117829.1, POC1B-AS1, CCDC18-AS1, THUMPD3-AS1, FLNB-AS1, SNHG11, HCG18, AL021707.2, UGDH-AS1, LINC00641, FGD5-AS1 and AC245452.1) from the TCGA-COAD dataset and use them to construct the risk model. After then, this pyroptosis-related lncRNA signature is validated in patients from the GSE17536 dataset. The COAD patients are divided into low-risk and high-risk groups by setting the median risk score as the cut-off point and represented differences in the immune microenvironment. Hence, we construct the immune risk model based on the infiltration levels of ssGSEA immune cells. Interestingly, the risk model and immune risk model are both independent prognostic risk factors. Therefore, a nomogram combined risk score, immune risk score with clinical information which is meaningful in univariate and multivariate Cox regression analysis is established to predict the overall survival (OS) of COAD patients. In general, the signature consisted of 15 pyroptosis-related lncRNAs and was proved to be associated with the immune landscape of COAD patients.
Collapse
Affiliation(s)
- Fada Xia
- Center for Molecular Medicine, Xiangya Hospital, Key Laboratory of Molecular Radiation Oncology of Hunan Province, Central South University, Changsha, China
| | - Yuanliang Yan
- Center for Molecular Medicine, Xiangya Hospital, Key Laboratory of Molecular Radiation Oncology of Hunan Province, Central South University, Changsha, China
| | - Cong Shen
- Center for Molecular Medicine, Xiangya Hospital, Key Laboratory of Molecular Radiation Oncology of Hunan Province, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
|
14
|
O’Malley DM, Alfano CM, Doose M, Kinney AY, Lee SJC, Nekhlyudov L, Duberstein P, Hudson SV. Cancer prevention, risk reduction, and control: opportunities for the next decade of health care delivery research. Transl Behav Med 2021; 11:1989-1997. [PMID: 34850934 PMCID: PMC8634312 DOI: 10.1093/tbm/ibab109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In this commentary, we discuss opportunities to optimize cancer care delivery in the next decade building from evidence and advancements in the conceptualization and implementation of multi-level translational behavioral interventions. We summarize critical issues and discoveries describing new directions for translational behavioral research in the coming decade based on the promise of the accelerated application of this evidence within learning health systems. To illustrate these advances, we discuss cancer prevention, risk reduction (particularly precision prevention and early detection), and cancer treatment and survivorship (particularly risk- and need-stratified comprehensive care) and propose opportunities to equitably improve outcomes while addressing clinician shortages and cross-system coordination. We also discuss the impacts of COVID-19 and potential advances of scientific knowledge in the context of existing evidence, the need for adaptation, and potential areas of innovation to meet the needs of converging crises (e.g., fragmented care, workforce shortages, ongoing pandemic) in cancer health care delivery. Finally, we discuss new areas for exploration by applying key lessons gleaned from implementation efforts guided by advances in behavioral health.
Collapse
Affiliation(s)
- Denalee M O’Malley
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Northwell Health Cancer Institute, New Hyde Park, NY, USA
| | - Catherine M Alfano
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Michelle Doose
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Anita Y Kinney
- Department of Epidemiology and Biostatistics, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Simon J Craddock Lee
- Harold C. Simmons Comprehensive Cancer Center, Department of Population and Data Sciences, UT-Southwestern, Dallas, TX, USA
| | - Larissa Nekhlyudov
- Harvard Medical School, Brigham & Womens’ Primary Care Medical Associates, Boston, MA, USA
| | - Paul Duberstein
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Northwell Health Cancer Institute, New Hyde Park, NY, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| |
Collapse
|
|
15
|
TOPCU R, YILDIRIM MB, ÖZKAN MB, ASLAN O, SEZİKLİ İ, ŞAHİN F. The effect of COVID-19 pandemic on inguinal hernia emergencies. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.975266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
|
16
|
Yeung T, Merchant J, Chen P, Smart C, Ghafoor H, Woodhouse F, James D, Symons N, Boyce S, Jones O, George B, Lindsey I. The Impact and Restoration of Colorectal Services during the COVID-19 Pandemic: A view from Oxford. SURGICAL PRACTICE 2021; 26:27-33. [PMID: 34899957 PMCID: PMC8652538 DOI: 10.1111/1744-1633.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
Aim The coronavirus pandemic has significantly disrupted the way we deliver healthcare worldwide. We have been flexible and creative in order to continue providing elective colorectal cancer operations and to restart services for benign cases during the recovery period of the pandemic. In this paper, we describe the impact of coronavirus on our elective services and how we have implemented new patient pathways to allow us to continue providing patient care. Patients and Methods Data on major colorectal elective resections were prospectively collected in an Enhanced Recovery After Surgery (ERAS) database. Data on the number of proctology cases and telemed appointments were collected from the hospital theatre information management system and electronic patient record system, respectively. Results During the pandemic, there was a complete shift towards cancer cases, with benign services and proctology cases being placed on hold. Hospital length of stay was reduced. We implemented earlier hospital discharge and more intense telephone follow‐up after elective major surgery. This has not resulted in an increase in postoperative complications, nor any increase in readmission to hospital. During the recovery phase, we have introduced a higher proportion of telemed consultations, including one‐stop telemed proctology clinics, resulting in straight to tests or investigations. Conclusion We have created a streamlined multidisciplinary pathway to reinstate our elective colorectal services as soon as possible and to minimise potential harm caused to patients whose treatment have been delayed. We anticipate many of these changes will be permanently incorporated into our clinical practice once the pandemic is over.
Collapse
Affiliation(s)
- Trevor Yeung
- Department of Colorectal Surgery Oxford University Hospitals UK.,Nuffield Department of Surgical Sciences University of Oxford UK
| | - Julia Merchant
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Patrick Chen
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Corinne Smart
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Hamira Ghafoor
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Fran Woodhouse
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - David James
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Nicholas Symons
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Stephen Boyce
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Oliver Jones
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Bruce George
- Department of Colorectal Surgery Oxford University Hospitals UK
| | - Ian Lindsey
- Department of Colorectal Surgery Oxford University Hospitals UK
| |
Collapse
|
|
17
|
Labalde Martínez M, García Borda FJ, Narvaez Chavez C, Vivas Lopez A, García Villar O, Gomez R, Ramos Martinez R, de La Cruz Vigo F, Ferrero Herrero E. Impact of the Covid-19 Pandemic on Colorectal Cancer Surgery in Madrid. JOURNAL OF COLOPROCTOLOGY 2021; 41:257-264. [DOI: 10.1055/s-0041-1730017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
Abstract
Introduction The Covid-19 pandemic has had an important impact on colorectal cancer surgery, for hospital resources had to be redistributed in favour of Covid-19 patients. The aim of the present study is to analyze our results in colorectal oncologic surgery during the Covid-19 pandemic in patients with and without perioperative SARS-CoV-2 infection.
Methods In total, 32 patients (19 male and 13 female patients), with a mean age of 64 years (range: 57.2 to 69.5 years) with colorectal cancer underwent surgery under the recommendations of surgical societies included in a protocol. Data collection included clinical characteristics (gender, age, body mass index, American Society of Anesthesiologists score, tumor location, preoperative staging, lymphopenia), data related to SARS-CoV-2 infection (postoperative symptoms, diagnostic tests), operative details (surgical procedure, approach, duration, stoma), pathological outcomes (tumor stage, number of lymph nodes harvested, distal and circumferential radial margins, quality of the total mesorectal excision), and surgical outcomes (morbidity, mortality, hospital stay, and the rates of reoperation and readmission).
Results A total of 3 (9.4%) patients who underwent colorectal surgery during the Covid-19 pandemic were infected by SARS-CoV-2 in the postoperative period. Chronic obstructive pulmonary disease was associated with Covid-19 (6.2% versus 33.3%; p = 0.042), and surgical morbidity was higher among Covid-19 patients (100% versus 37.9%; p = 0.039). There were not significant differences between COVID-19 patients and non-COVID-19 patients in relation to the rest of the analyzed outcomes.
Conclusion During the Covid-19 pandemic, colorectal cancer surgery should be performed according to the recommendations of surgical societies. However, Covid-19 patients could present a higher morbidity rate.
Collapse
Affiliation(s)
- Maria Labalde Martínez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Francisco Javier García Borda
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cristina Narvaez Chavez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alfredo Vivas Lopez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Oscar García Villar
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ramón Gomez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Rafael Ramos Martinez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Felipe de La Cruz Vigo
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Eduardo Ferrero Herrero
- Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
|
18
|
Sánchez-Guillén L, Jimenez-Rodriguez RM. Special surgical approaches during peri-COVID-19 pandemic: Robotic and transanal minimally invasive surgery. World J Gastrointest Surg 2021; 13:529-536. [PMID: 34194611 PMCID: PMC8223704 DOI: 10.4240/wjgs.v13.i6.529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023] Open
Abstract
During the peri-coronavirus disease 2019 pandemic, the need of special care has raised, not only for our patients but also for health care workers. These needs are different regarding the procedure and the approach performed. This is a dynamic review in the use of robotics and transanal approaches for colorectal diseases. We searched PubMed and KSREvidence.com for studies related to coronavirus disease and robotic surgery/transanal mesorectal excision/transanal surgery (primary and systematic reviews). From 147 results in PubMed, 11 were selected for full text screening, and 11 were included in this paper. From 3 results in KSREvidence, no relevant systematic reviews were identified. We also checked the references in identified papers for further relevant studies. European Society of Coloproctology guidelines were including as part of the recommendations available. Robotic and transanal MIS can be performed safely during the pandemic, but particular characteristics of these procedure need to be taken into consideration.
Collapse
Affiliation(s)
- Luis Sánchez-Guillén
- Department of Cirugía General, Hospital Universitario de Elche, Elche 03201, Spain
| | - Rosa M Jimenez-Rodriguez
- Department of Surgery, Hospital Universitario Virgen del Rocio, Unidad de Coloproctologia, Sevilla 41013, Spain
| |
Collapse
|
|
19
|
Surek A, Ferahman S, Gemici E, Dural AC, Donmez T, Karabulut M. Effects of COVID-19 pandemic on general surgical emergencies: are some emergencies really urgent? Level 1 trauma center experience. Eur J Trauma Emerg Surg 2021; 47:647-652. [PMID: 33136190 PMCID: PMC7604226 DOI: 10.1007/s00068-020-01534-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/17/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE The aim of this paper is to investigate the effect of COVID-19 pandemic on general surgical emergencies as well as analyzing the effectiveness of measures taken in reducing the incidence of COVID-19 in patients and healthcare professionals. METHODS Patients who underwent emergency surgery between the pandemic period of March 14th to May 15th 2020 and within the same period from the previous year were reviewed retrospectively. COVID-19 incidence in patients and health professionals working in the general surgery department during these periods was questioned. RESULTS Demographic data were similar between the two time periods. The number of patients who underwent surgery in the pandemic group (n = 103) was lower than the control group (n = 252). There was a 59.1% reduction in emergency surgeries. The biggest decreases were the admissions of incarcerated hernia, uncomplicated appendicitis and acute cholecystitis (92%, 81.3%, 47.3%, respectively). During the pandemic, an increase was of patient rates who underwent surgery for complicated appendicitis and AMIO (p = 0.001, p = 0.019, respectively). The rate of mortality was higher in patients who underwent emergency surgery during pandemic (p = 0.049). The results of COVID-19 screening were positive in 6 (6/103, 5.82%) patients undergoing emergency surgery. None of the doctors working in the ward were infected with COVID-19 infection (0/20). The screening tests were positive in only two nurses working on the ward (2/24, 8.33%). CONCLUSION In this and similar pandemics, we suggest that a new algorithm is necessary to approach emergencies and the results of this study can contribute to that end.
Collapse
Affiliation(s)
- Ahmet Surek
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey.
| | - Sina Ferahman
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey
| | - Eyup Gemici
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey
| | - Ahmet Cem Dural
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey
| | - Turgut Donmez
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey
| | - Mehmet Karabulut
- Department of General Surgery, Turkish Ministry of Health, University of Health Sciences (UHS), Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Level 4, Tevfik Saglam Cad. Nr:11, Bakirkoy, Istanbul, Turkey
| |
Collapse
|
|
20
|
Alam W, Bouferraa Y, Haibe Y, Mukherji D, Shamseddine A. Management of colorectal cancer in the era of COVID-19: Challenges and suggestions. Sci Prog 2021; 104:368504211010626. [PMID: 33878982 PMCID: PMC10358474 DOI: 10.1177/00368504211010626] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Coronavirus (COVID-19) pandemic had a huge impact on all sectors around the world. In particular, the healthcare system has been subject to an enormous pressure that has surpassed its ability in many instances. Additionally, the pandemic has called for a review of our daily medical practices, including our approach to colorectal cancer management where treatment puts patients at high risk of virus exposure. Given their higher median age, patients are at an increased risk for severe symptoms and complications in cases of infection, especially in the setting of immunosuppression. Therefore, a review of the routine colorectal cancer practices is needed to minimize risk of exposure. Oncologists should weigh risk of exposure versus the patient's oncologic benefits when approaching management. In addition, treatment protocols should be modified to minimize hospital visits and admissions while maintaining the same treatment efficacy. In this review, we will focus on challenges that colorectal cancer patients face during the pandemic, while highlighting the priority in each case. We will also discuss the evidence for potential modifications to existing treatment plans that could reduce infectious exposure without compromising care. Finally, we will discuss the impact of the socio-economic difficulties faced by Lebanese patients due to a poor economy toppled by an unexpected pandemic.
Collapse
Affiliation(s)
- Walid Alam
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Youssef Bouferraa
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yolla Haibe
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
|
21
|
Tejedor P, Simó V, Arredondo J, López-Rojo I, Baixauli J, Jiménez LM, Gómez-Ruiz M, Pastor C. The impact of SARS-CoV-2 infection on the surgical management of colorectal cancer: lessons learned from a multicenter study in Spain. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:85-91. [PMID: 33261501 DOI: 10.17235/reed.2020.7460/2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
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.
Collapse
Affiliation(s)
- Patricia Tejedor
- Cirugía General y Apto. Digestivo / Colorrectal, Hospital Universitario 'Gómez Ulla', España
| | - Vicente Simó
- Cirugía General, Complejo Asistencial Universitario de León, España
| | - Jorge Arredondo
- Cirugía General, Complejo Asistencial Universitario de León, España
| | | | | | | | | | - Carlos Pastor
- Cirugía General, Clínica Universidad de Navarra, España
| | | |
Collapse
|
|
22
|
Antikchi MH, Neamatzadeh H, Ghelmani Y, Jafari-Nedooshan J, Dastgheib SA, Kargar S, Noorishadkam M, Bahrami R, Jarahzadeh MH. The Risk and Prevalence of COVID-19 Infection in Colorectal Cancer Patients: a Systematic Review and Meta-analysis. J Gastrointest Cancer 2021; 52:73-79. [PMID: 32997314 PMCID: PMC7524641 DOI: 10.1007/s12029-020-00528-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with cancer might be at an increased risk of infection with COVID-19 and a more severe disease course. However, different tumor types have differing susceptibility to the infection and COVID-19 phenotypes. Thus, the risk and prevalence of COVID-19 is not uniform across the different tumor types. Here, we performed a meta-analysis to estimate the risk and prevalence of COVID-19 infection in colorectal cancer (CRC) patients. METHODS A comprehensive literature search was performed up to July 25, 2020, thorough PubMed, Web of Science, Scopus, Google Scholar, CNKI, CBM, China Science, Wan Fang, and SciELO databases. The risk of COVID-19 infection in CRC patients was performed based on the odds ratios (ORs) and 95% confidence interval (95% CI). RESULTS A total of six studies with 204 different cancer patients with COVID-19 and 92 CRC infected patients with COVID-19 were selected. Our results showed that the prevalence of COVID-19 infection in CRC patients was 45.1% in the global population. The pooled data showed that there is no a significant risk of infection with COVID-19 in CRC patients in the global population (OR = 0.261, 95% CI 0.099-0.533, p = 0.082). However, when subgroup analysis was performed based on country of origin, we found a significant correlation in Chinese CRC patients (OR = 0.221, 95% CI 0.146-0.319, p ≤ 0.001). CONCLUSIONS This study results revealed that Chinese CRC patients harbored a higher risk of COVID-19 infection. However, more multicenter, larger sample sizes and high-quality studies are required to verify this meta-analysis result.
Collapse
Affiliation(s)
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yaser Ghelmani
- Clinical Research Development Center of Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jamal Jafari-Nedooshan
- Department of General Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shadi Kargar
- Department of General Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Noorishadkam
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Bahrami
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
|
23
|
Xu H, Zhou Y, Sun R, Liu X, Diao M, Ren X, Li L. A narrative review of the challenges and countermeasures in hepatoblastoma management during COVID-19 epidemic. Transl Pediatr 2020; 9:840-848. [PMID: 33457307 PMCID: PMC7804479 DOI: 10.21037/tp-20-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/22/2020] [Indexed: 11/27/2022] Open
Abstract
An infectious disease named "coronavirus disease 2019" (COVID-19) currently has brought a threat to global health security and trends to be more and more severe in many countries. It also has introduced great challenges to the diagnosis and management of children with hepatoblastoma (HB). During the COVID-19 pandemic, pediatric surgeons should not only develop personalized treatment plans for HB therapy, but also emphasize the diagnosis, prevention, and treatment of this virus. Children with both HB and COVID-19 are recommended to undertake multidisciplinary assessment. Anti-SARS-CoV-2 therapy may be a preferred treatment for the infected without presenting a surgical emergency. However, emergent operation may be necessary for HB children with concurrent COVID-19 who developed a life-threatening surgical emergency condition. Otherwise, for children with negative virus examination results, treatment advice should be based on the impact of the epidemic and regional economic considerations. A "wait and see" strategy is recommended for children with resectable tumors after new adjuvant chemotherapy treatment (NACT). Assessment of liver transplantation is recommended for children with HB whose tumors cannot be resected after NACT. Children with HB with pulmonary metastasis may have abnormal findings on chest imaging due to COVID-19. Besides, the detailed therapeutic regimens may vary for children with HB with or without an emergency presentation. Based on previous consensus, current research, and the experiences of our hospital, we aim to offer available management plans for the above-mentioned concerns.
Collapse
Affiliation(s)
- Hang Xu
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
| | - Yan Zhou
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui Sun
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuelai Liu
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
| | - Mei Diao
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianghai Ren
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Long Li
- Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
|
24
|
Cancino RS, Su Z, Mesa R, Tomlinson GE, Wang J. The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities. JMIR Cancer 2020; 6:e21697. [PMID: 33027039 PMCID: PMC7599065 DOI: 10.2196/21697] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022] Open
Abstract
Cancer is a leading cause of death in the United States and across the globe. Cancer screening is an effective preventive measure that can reduce cancer incidence and mortality. While cancer screening is integral to cancer control and prevention, due to the COVID-19 outbreak many screenings have either been canceled or postponed, leaving a vast number of patients without access to recommended health care services. This disruption to cancer screening services may have a significant impact on patients, health care practitioners, and health systems. In this paper, we aim to offer a comprehensive view of the impact of COVID-19 on cancer screening. We present the challenges COVID-19 has exerted on patients, health care practitioners, and health systems as well as potential opportunities that could help address these challenges.
Collapse
Affiliation(s)
- Ramon S Cancino
- Department of Family & Community Medicine, Joe R & Teresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, United States
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
| | - Ruben Mesa
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
- Department of Medicine, Joe R & Teresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, United States
| | - Gail E Tomlinson
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
- Department of Pediatrics, Joe R & Teresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
- School of Nursing, UT Health San Antonio, San Antonio, TX, United States
| |
Collapse
|
|
25
|
Gunadi ., Idham Y, Paramita VMW, Fauzi AR, Dwihantoro A, Makhmudi A. The Impact of COVID-19 pandemic on pediatric surgery practice: A cross-sectional study. Ann Med Surg (Lond) 2020; 59:96-100. [PMID: 32953094 PMCID: PMC7491416 DOI: 10.1016/j.amsu.2020.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 01/12/2023] Open
Abstract
Background Since the COVID-19 pandemic was declared by the World Health Organization on March 11, 2020, routine clinical practices were affected, including pediatric surgery services. We aimed to compare pediatric surgery practices, including the number and types of surgery, either elective or emergency surgeries and outpatient services, before the outbreak and during the COVID-19 pandemic in our institution. Material and methods We retrospectively compared pediatric surgery practices, including elective and emergency surgeries, and outpatient services between the previous one-year period (March 2019–February 2020), the last three months of that period (December 2019–February 2020) before the outbreak, and the three months (March–May 2020) during the COVID-19 pandemic in our hospital. Results The frequency of elective surgeries during the pandemic was lower than during the last three months before the outbreak: 61 vs. 18 (~3-fold), 19 vs. 13 (~1.5-fold), 19 vs. 5 (~4-fold), and 30 vs. 15 (~2-fold) for digestive, neonate, urology and oncology cases, respectively. No laparoscopic procedures were performed during the pandemic compared with the one-year period before the outbreak (0 vs. 16 cases). The frequency of all emergency pediatric procedures before and during the COVID-19 pandemic was similar (29 vs. 20 cases, respectively). Moreover, a declining trend was also clearly apparent in the outpatient services during the pandemic compared with before the outbreak, both in the new and the established patients. Conclusions The pediatric surgery practices in our institution have been severely affected by the COVID-19 pandemic, including elective and outpatient services. This setback needs a comprehensive strategy to avoid morbidity from the neglected elective surgeries during the pandemic, including the proper comparison between the real risk of COVID-19 cross-infection and the benefits of elective procedures.
Since the COVID-19 pandemic was declared by the World Health Organization on March 11, 2020, routine clinical practices were affected, including pediatric surgery services. The pediatric surgery practices have been severely affected by the COVID-19 pandemic, including the elective and outpatients' services. This setback needs a comprehensive strategy to avoid morbidity from the neglected elective surgeries during the pandemic, including the proper comparison between the real risk of COVID-19 cross-infection and the benefits of elective procedures.
Collapse
|
|
26
|
Woodhouse F, Yeung T. Impact of COVID-19 on stoma care: the experience of one team in Oxford. ACTA ACUST UNITED AC 2020; 29:S4-S6. [PMID: 32901544 DOI: 10.12968/bjon.2020.29.16.s4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Trevor Yeung
- Specialist Registrar in Colorectal Surgery, Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust
| |
Collapse
|
|
27
|
Siavashpour Z, Taghizadeh-Hesary F, Rakhsha A. Recommendations on Management of Locally Advanced Rectal Cancer During the COVID-19 Pandemic: an Iranian Consensus. J Gastrointest Cancer 2020; 51:800-804. [PMID: 32656628 PMCID: PMC7355082 DOI: 10.1007/s12029-020-00454-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Today, the rapid outbreak of COVID-19 is the leading health issue. Patients with cancer are at high risk for the development of morbidities of COVID-19. Hence, oncology centers need to provide organ-based recommendations for optimal management of cancer in the COVID-19 era. METHODS In this article, we have provided the recommendations on management of locally advanced rectal cancer during the COVID-19 pandemic based on our experience in Shohada-e Tajrish Hospital, Iran. RESULTS We recommend that patients with locally advanced rectal cancer should be managed in an individualized manner in combination with local conditions related to COVID-19. CONCLUSION Our recommendation may provide a guide for oncology centers of developing countries for better management of locally advanced rectal cancer.
Collapse
Affiliation(s)
- Zahra Siavashpour
- Department of Radiation Oncology, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Taghizadeh-Hesary
- Department of Radiation Oncology, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Rakhsha
- Department of Radiation Oncology, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
28
|
Campos FG, Fillmann HS. Potential impact of COVID-19 on colorectal disease management. JOURNAL OF COLOPROCTOLOGY 2020. [PMCID: PMC7303621 DOI: 10.1016/j.jcol.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractThe current recommendations for management of colorectal diseases are still evolving, due to the limited experience on this issue. As the new coronavirus can be transmitted through breath droplets, by contact and orofecally, there is no consensus of how this fact may affect the investigation and treatment of anorectal diseases. Thus, high-quality multicenter studies are urgently needed to provide better information to both patients and the multiprofessional team, in order to build an effective pandemic response plan in our specialty. As a greater operative risk for infected patients has already been demonstrated, the next step lies on the identification of new therapeutic strategies that could minimize this effect on an individual basis. There is a present understanding that the COVID-19 pandemic should change some traditional practices. Therefore, the surgical treatment of suspected or known COVID-19 case demands specific insights. This article analyses potential influences regarding the treatment of patients with Colorectal Cancer (CRC) and Inflammatory Bowel Diseases (IBD). At present, elective surgery must be avoided, and the colorectal surgeon must carefully evaluate the risks and benefits of such decision. Within this context, a change toward nonsurgical and less aggressive modalities of CRC treatment may help to postpone definitive treatment. We also discuss the concerns regarding the viral infection among the population, the influence on clinical symptoms and the proposed modifications on therapeutic schemes.
Collapse
Affiliation(s)
- Fábio Guilherme Campos
- Universidade de São Paulo, Hospital das Clínicas, Divisão de Cirurgia Colorretal, Departamento de Gastroenterologia em, São Paulo, SP, Brazil
- Corresponding author.
| | - Henrique Sarubbi Fillmann
- Division of Colorectal Surgery, Department of Surgery of Faculdade de Medicina, Universidade PUCRS, Porto Alegre, RS, Brazil
| |
Collapse
|
|
29
|
Hyung J, Kim TW. The Asian Approach to the Management of Gastrintestinal Cancer Patients During the COVID-19 Pandemic Era. Clin Colorectal Cancer 2020; 19:151-152. [PMID: 32723497 PMCID: PMC7347337 DOI: 10.1016/j.clcc.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Jaewon Hyung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea.
| |
Collapse
|
|
30
|
Lee JJ, Chu E. The UPMC Hillman Cancer Center Approach to the Management of Colorectal Cancer During the COVID-19 Pandemic Era. Clin Colorectal Cancer 2020; 19:146-148. [PMID: 32811719 PMCID: PMC7347322 DOI: 10.1016/j.clcc.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 01/12/2023]
Affiliation(s)
- James J Lee
- Division of Hematology-Oncology, Department of Medicine, Cancer Therapeutics Program, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Edward Chu
- Division of Hematology-Oncology, Department of Medicine, Cancer Therapeutics Program, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| |
Collapse
|
|
31
|
Zhou Y, Xu H, Li L, Ren X. Management for patients with pediatric surgical disease during the COVID-19 epidemic. Pediatr Surg Int 2020; 36:751-752. [PMID: 32307559 PMCID: PMC7167361 DOI: 10.1007/s00383-020-04656-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Yan Zhou
- Department of Pediatric Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020 China ,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Hang Xu
- Department of Pediatric Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020 China
| | - Long Li
- Department of Pediatric Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020 China ,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Xianghai Ren
- Department of Pediatric Surgery, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020 China ,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China ,Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| |
Collapse
|
|
32
|
Govil D, Dhankhar D, Gupta R, Kumar S. Gastrointestinal cancer surgery during COVID times. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_79_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|