IMPACT OF THE COVID-19 PANDEMIC ON SURGICAL TREATMENT OF COLORECTAL CANCER IN UNIVERSITY HOSPITAL OF SPLIT

Cilj istraživanja: Cilj ovoga istraživanja bio je odrediti utjecaj COVID-19 pandemije na kirurško liječenje kolorektalnog karcinoma odnosno utvrditi razlike u broju i ishodu hitnih i elektivnih operacija te laparoskopskih i klasičnih metoda između 2019. i 2020. godine. Ispitanici i metode: Ispitanici su svi bolesnici liječeni zbog kolorektalnog karcinoma u Klinici za kirurgiju, Odjel abdominalne kirurgije, u razdoblju od 1. siječnja 2019. do 31. prosinca 2020. U sklopu istraživanja, bolesnicima su analizirani sljedeći parametri: dob, spol, tip operacije, uzrok hitne operacije, tip elektivne operacije, postavljenje anastomoze ili stome, duljina hospitalizacije, komplikacije te patohistološki nalazi. Rezultati: Tijekom 2019. i 2020. godine operirano je 636 bolesnika (41% žena, medijana životne dobi 71 i 59% muškaraca, medijana životne dobi 70). U 2019. operirano je 52 ispitanika više nego u 2020. godini (P=0,039) te je bilo za 2,2 puta više elektivnih (n=236) nego hitnih operacija (n=108). U 2020. godini za 2,4 puta više je bilo elektivnih (n=207) operativnih zahvata nego hitnih (n=85), a statistički značajne razlike razdiobe broja elektivnih i hitnih operacija između dviju godina nije bilo (P=0,590). Od ukupnog broja hitno operiranih kolorektalnih karcinoma u obje godine, ileus je uzrok u 168 slučajeva, dok su perforacija i peritonitis bili prisutni u 25 slučajeva. Najmanji broj poslijeoperacijskih komplikacija razvili su bolesnici operirani elektivno laparoskopskom metodom (2%) (P=0,032), dok je razlika između onih operiranih elektivno klasično (8%) i hitno klasično (10%) bila minimalna (P=0,527). Dokazana je značajna razlika duljine hospitalizacije u odnosu na tipove operacije (P<0,001). Najduža hospitalizacija je kod elektivnih klasičnih zahvata, ona je za 1 dan duža nego kod hitnih klasičnih zahvata (P<0,001) i za 1 dan je duža nego kod elektivnih laparoskopskih zahvata (P<0,001). Zaključci: COVID-19 pandemija tijekom 2020. godine nije utjecala na broj elektivnih i hitnih operacija kolorektalnog karcinoma u KBC-u Split u odnosu na 2019. godinu.Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the surgical treatment of colorectal cancer and to compare the differences in the number and outcome of emergency and elective surgeries, laparoscopic and classical methods between 2019 and 2020. Patients and methods: All subjects were patients treated for colorectal cancer at the Clinic of Surgery, Department of Abdominal Surgery, in the period from January 1st, 2019 to December 31st, 2020. The subjects were analyzed according to the following parameters: age, sex, type of operation, cause of emergency surgery, type of elective surgery, placement of anastomosis or stoma, length of hospitalization, complications, and pathohistological findings. Results: During 2019 and 2020, 636 patients were treated for colorectal cancer (41% women, median age 71 and 59% men, median age 70). In 2019, 52 more subjects were treated comparing the numbers in 2020 (P=0.039) and there were 2.2 times more elective (n=236) than emergency operations (n=108). In 2020, there were 2.4 times more elective (n=207) surgical procedures than emergency procedures (n=85), and there were no statistically significant differences in the distribution of the number of elective and emergency operations between the two years (P=0.590). Out of the total number of urgently operated on colorectal cancer in both years, ileus was the cause in 168 cases, while perforation and peritonitis were present in 25 cases. The lowest number of postoperative complications was developed by patients operated electively by laparoscopic method (2%) (P=0.032), while the difference between those operated electively classically (8%) and urgently classically (10%) was minimal (P=0.527). There was a significant difference in the length of hospitalization in relation to the types of surgery (P<0.001). The longest hospitalization was in elective classical procedures, it was 1 day longer than in emergency classical procedures (P<0.001) and 1 day longer than in elective laparoscopic procedures (P