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. 2022 Apr;74(2):619-628.
doi: 10.1007/s13304-022-01264-y. Epub 2022 Mar 3.

Feasibility and usability of a regional hub model for colorectal cancer services during the COVID-19 pandemic

Filipe Carvalho  1 , Ailín C Rogers  1 , Tou-Pin Chang  1 , Yinshan Chee  1 , Dhivya Subramaniam  1 , Gianluca Pellino  2   3 , Katy Hardy  1 , Christos Kontovounisios  4   5   6 , Paris Tekkis  1   7   8 , Shahnawaz Rasheed  1 ; London Colorectal Cancer Hub Network Collaborators
Collaborators, Affiliations

Feasibility and usability of a regional hub model for colorectal cancer services during the COVID-19 pandemic

Filipe Carvalho et al. Updates Surg. 2022 Apr.

Abstract

The outbreak of the COVID-19 pandemic produced unprecedented challenges, at a global level, in the provision of cancer care. With the ongoing need in the delivery of life-saving cancer treatment, the surgical management of patients with colorectal cancer required prompt significant transformation. The aim of this retrospective study is to report the outcome of a bespoke regional Cancer Hub model in the delivery of elective and essential colorectal cancer surgery, at the height of the first wave of the COVID-19 pandemic. 168 patients underwent colorectal cancer surgery from April 1st to June 30th of 2020. Approximately 75% of patients operated upon underwent colonic resection, of which 47% were left-sided, 34% right-sided and 12% beyond total mesorectal excision surgeries. Around 79% of all resectional surgeries were performed via laparotomy, and the remainder 21%, robotically or laparoscopically. Thirty-day complication rate, for Clavien-Dindo IIIA and above, was 4.2%, and 30-day mortality rate was 0.6%. Re-admission rate, within 30 days post-discharge, was 1.8%, however, no patient developed COVID-19 specific complications post-operatively and up to 28 days post-discharge. The established Cancer Hub offered elective surgical care for patients with colorectal cancer in a centralised, timely and efficient manner, with acceptable post-operative outcomes and no increased risk of contracting COVID-19 during their inpatient stay. We offer a practical model of care that can be used when elective surgery "hubs" for streamlined delivery of elective care needs to be established in an expeditious fashion, either due to the COVID-19 pandemic or any other future pandemics.

Keywords: COVID-19; Cancer; Colorectal surgery; SARS-CoV-2.

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Conflict of interest statement

The authors declare that that they have no conflicts of interest and that this study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors affirm that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Figures

Fig. 1
Fig. 1
RM Partners Cancer Hub participating London NHS Trusts and geographical location. 1—Royal Marsden Hospital/RM Partners Cancer Hub; 2—Chelsea and Westminster NHS Foundation Trust; 3—St George’s University Hospital NHS Foundation Trust; 4—London North West University Healthcare NHS Trust/St Mark’s Hospital; 5—Croydon Health Services NHS Trust; 6—Epsom and St Helier University Hospital NHS Trust; 7—The Hillingdon Hospital NHS Foundation Trust
Fig. 2
Fig. 2
Cancer hub pathway
See this image and copyright information in PMC

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