The Effects of Nasocomial SARS-CoV-2 Infection after Elective Gastrointestinal Oncologic Procedures: Single Center 30-day Follow-up Results

Abstract

Although there is extensive debate for the best treatment strategies, limited studies, which reflect the effects of postoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on mortality and hospital stay after elective gastrointestinal oncologic procedures were published. In order to contribute to the existing literature, a single-center, retrospective, cross-sectional study, including 301 patients who underwent elective gastrointestinal oncological procedures was planned. Patients’ data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and SARS-CoV-2 preoperative screening tests were recorded. Four of them were postponed due to positive preoperative screening for SARS-CoV-2. 395 procedures were performed due to cancer originating from colon (105), rectum (91), stomach (74), periampullar region (16), distal pancreas (4), esophagus (3), retroperitoneum (2), ovary (2), endometrium (1), spleen (1) and small bowel (2). Laparoscopy was the approach of choice for 44 patients (14.7% vs. 85.3%). In the postoperative period, two patients were infected with SARS-CoV-2 and one of them died in the intensive care unit (n=1/2, 50% mortality). Two patients died due to surgical complications unrelated to SARS-CoV-2 (n=2/299, 0.67% mortality) (p<0.01). The mean hospital stay was longer in patients with SARS-CoV-2 infection (21.5 ± 9.1 – 8.2 ± 5.2 days, respectively, p<0.01). 298 patients were safely discharged (99%). During the pandemic elective gastrointestinal oncologic procedures may be safely performed; however, preoperative testing, precautions to minimize contamination should be performed strictly to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high and hospital stay is also significantly increased.