Yuksel Altinel, Department of General Surgery, Bagcilar Research and Training Hospital, Health Science University, Istanbul, Turkey
Yunus Emre Aktimur, Department of General Surgery, Bagcilar Research and Training Hospital, Health Science University, Istanbul, Turkey
Kamil Ozdogan, Department of General Surgery, Bagcilar Research and Training Hospital, Health Science University, Istanbul, Turkey
Serhat Meric, Department of General Surgery, Bagcilar Research and Training Hospital, Health Science University, Istanbul, Turkey
Hakan Yigitbas, Department of General Surgery, Bagcilar Research and Training Hospital, Health Science University, Istanbul, Turkey
Objective: Colectomy is a standard surgical technique for colon cancer, but the prognostic indexes are limited. We aimed to evaluate clinicopathology of colectomies under emergency and elective conditions due to colon cancer, and correlate prognostic indexes with these outcomes collected before and during COVID-19 pandemic. Method: Clinicopathological and laboratory findings of 250 patients underwent colectomies under elective and emergency conditions for left and right colon cancer between 2017 and 2021 were retrospectively analyzed. Prognostic markers, including Clavien-Dindo Classification (CDC), Frailty index (FI), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, and Charlson Comorbidity Index (CCI) were used. Results: CDC Grade 2 was the most common grade in both periods for all patients (p = 0.014) and for elective cases (p = 0.006), but not FI and HALP scores. Frequency of perineural invasion was significantly higher during COVID-19 among elective cases (19.8% vs. 40.6%; p = 0.032). Increase in CDC (OR: 0.123; 95%CI: 0.331-1.393; p = 0.007) and in CCI (OR: 0.067; 95% CI: 0.147-1.158; p = 0.028) primarily affected mortality rate during pandemic. Conclusions: Our analyses revealed short-term influences of COVID-19 pandemic on patients’ surgical care of the colon cancer patients. The operative management of comorbidities, CDC for complications, and CCI for comorbidities might be helpful tools to identify post-operative mortality of colectomies.
Keywords: Colon cancer. Colectomy. Morbidity. Frailty index.