68 Outcomes of Emergency Appendicectomy At Torbay Hospital During Peak SARS-COV-2 Pandemic

Abstract

Abstract Introduction SARS-COV-2 has created unprecedented challenges for healthcare systems. As a result, new intercollegiate guidelines have been published in the UK to manage emergency surgeries commencing 25th March 2020. Devon has one of the lowest incidences of Covid-19 in UK. In this study, we report outcomes of emergency appendicectomy at Torbay Hospital during peak COVID-19 pandemic, from 25th March till 26th May 2020. Method This is a single centre retrospective review at Torbay Hospital, Devon. It includes all patients who underwent emergency appendicectomy. Primary outcomes were intra-operative findings, change of operation choice due to revised guidelines, and length of admission. The secondary outcome was 14 days post-operative mortality and morbidity. Results A total of 29 patients, median age 33.1, underwent emergency appendicectomy. 79.3% (n = 23) had a pre-operative SARS-COV-2 nasal swab test, all of which were negative. All appendicectomies were conducted in a non-COVID theatre. Level 3 PPE and precautions were used intra-operatively. The choice of operation was changed in 37.9% (n = 10), from laparoscopic to open as per COVID-19 guidelines. Most patients (86.2%) were discharged from hospital within 5 days of operation. None of the patients or surgeons contracted COVID-19 related infection in 14 days following the operation. Conclusions This study is a snapshot into safety of operative management of acute appendicitis in patients not suspected of COVID-19 infection during first wave of pandemic. However, it will be interesting to see long-term multi-centre comparative studies analysing the effect of surgical management of appendicitis during all three waves of pandemic.