Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

N-alkylamino peptoid homooligomers.

International audienc

Synthesis and characterization of a hybrid material (C10H28N4) [CoCl4]2 using Hirshfeld surface, vibrational and optical spectroscopy, DFT calculations and biological activities

International audienceThe preparation and structural characterization of a new complex compound (C10H28N4) [CoCl4]2 (abbreviated BAPCO) were reported. The crystal was grown by the room temperature slow evaporation method and characterized by single crystal X-Ray diffraction. The functional groups present in BAPCO were characterized by several techniques such as FT-IR, UV-Vis absorption and photoluminescence spectroscopy, thermal measurement, Hirshfeld surface analysis and DFT investigation. The title compound crystallizes in the P21/n space group of the monoclinic system with the following cell parameters: a = 18.5765(11) Å, b = 7.1390(4) Å, c = 18.6346(11) Å, β = 110.858(3)°, Z = 4 and V = 2309.3(2) Å3. The structure consists of an alternation along the a-axis of organic layers formed by [C10H28N4]4+cations and inorganic layers built up of isolated tetrahedral [CoCl4]2−. The crystal cohesion is ensured by a network of Nsingle bondH … Cl and Csingle bondH … Cl hydrogen bonds. Vibrational and optical properties were explored by means of experimental techniques along with DFT and TDDFT calculations. Furthermore, frontier molecular orbital analysis (HOMO-LUMO) was accomplished to understand the chemical stability of BAPCO, and the activation of thermodynamic parameters are calculated. Good agreement was found between theoretical and experimental results. The bioassay results showed that the structure exhibits significant antibacterial activity

Synthesis, crystal structure, spectroscopic study and Hirshfeld surface analysis of [Ni(C6H8N2)3]Cl2.2(H2O) (1)

International audienceThe title compound, [Ni(C 6 H 8 N 2 ) 3 ]Cl 2 .2(H 2 O), was synthesized by slow evaporation method at room tem- perature. The structural study by X–ray diffraction indicate that this compound crystallize in the tri- clinic system, P-1 space group with a = 10.222(2) ˚A, b = 10.757(2) ˚A, c = 11.441(3) ˚A, α= 114.30(4) °, β= 99.43(3) °and γ= 93.01(3) °. The structure is formed by the cation [Ni(C 6 H 8 N 2 ) 3 ] 2 + , tow chloride an- ions and two molecules water of crystallization. The nickel (II) atom is coordinated to six nitrogen donors from three neutral 2-AMP ligands, adopting a slightly distorted octahedral geometry. The crystal struc- ture is stabilized by strong hydrogen bonds of N–H…Cl, O–H…Cl, C–H…Cl and π–πinteractions to ob- tained three–dimensional network. The newly prepared compound was characterized by XRD, Infrared, UV–Vis spectroscopy and Hirshfeld surface (3D-HS) analysis. Vibrational analysis of the compound was realized by infrared spectroscopy. The optical properties of the crystal were studied using optical absorp- tion UV–visible spectroscopy which confirmed the semiconducting properties by revealing a direct optical band. Hirshfeld Surface projections and Fingerprint plots were elucidated the relative contribution of the H…Cl, C…H, C…C, C…N, H…O intermolecular contacts in the crystal