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J.Jpn. Surg. Soc.. 122(6): 618-624, 2021

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Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan

Masayuki Watanabe, Takeshi  Sano

The COVID-19 pandemic has significantly affected surgical treatment. Many surgeries were postponed or canceled worldwide due to the lack of hospital resources and equipment. An estimated 979,000 excess deaths occurred in 2020 in the 29 high-income countries. The estimated number of excess deaths substantially exceeded the number of reported deaths from COVID-19, suggesting that the restriction of medical services due to the pandemic might have influenced the increase. During the pandemic, surgical triage was required to allocate medical resources appropriately according to the shortfalls in medical service, the severity of illness, operative urgency, and each patient’s condition. A multidisciplinary team approach is essential for triage in cancer surgery. Emergency operations should be conducted, if required, with all the safety precautions to prevent SARS-CoV-2 transmission. Perioperative SARS-CoV-2 infection is associated with an increased risk of morbidity and mortality. To decrease the risk of operative mortality in patients after SARS-CoV-2 infection, elective surgeries should be postponed for 4–7 weeks. Delays in cancer diagnosis due to the pandemic possibly worsen the prognosis of patients. Urgent research using big data is mandatory to elucidate the real-world effects of COVID-19 on surgery.

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