FTP2.4 Colorectal Resections at an Elective Hub; A service evaluation

Abstract

Abstract Aim Rising acute hospital bed pressures that have persisted post-pandemic have led to increased surgical cancellations and growing waiting lists. Ashford and St Peters Hospital Trust set up a unique elective surgical hub at Ashford Hospital to ensure the continued provision of surgical services, unaffected by the capacity pressures of an acute hospital site. The introduction of a level 1.5 Enhanced Care Unit (ECU) has enabled many colorectal resections to be performed at the elective hub. We aim to evaluate elective colorectal resections at this hub since the introduction of ECU. Methods Evaluated all elective colorectal resections in the 12 month period since the introduction of ECU (1st April 2021 - 31st March 2022). Procedure, surgical approach, histology, length of stay, post-operative complications and inter-hospital transfers were recorded for each case. Statistical analysis was performed on the data collected. Results In 12 months,169 and 36 colorectal resections took place at the acute site versus the elective respectively. At the elective hub, 50% of patients were male, the median age was 62.5 yrs, 89% were ASA 2. Right hemicolectomy was the most common procedure (50%) followed by high anterior resection (36%). The open conversion rate was 8%. Three patients (8%) required transfer to St Peter’s, 2 of which had an anastomotic leak. Conclusions An elective hub provides a safe location for colorectal resections. Appropriate case selection involving consultant surgeons and anaesthetists ensures low transfer rates. Expanding this service will relieve bed pressures at St Peters and reduce waiting lists.