Impact of COVID-19 on Elective Colorectal Resections in a District General Hospital

Abstract

Background: COVID-19 is a global pandemic having direct impact on elective surgical health care services, ultimately leading to short & long-term consequences. Aims: A single-center, retrospective study of prospectively collected data was conducted, aimed to identify the impact of COVID-19 pandemic on clinical outcome of elective time critical colorectal resections and analyse the mitigating strategies to reduce the adverse clinical outcome. Materials & Methods: Clinical data of patients who underwent time critical elective colorectal resections at our center in COVID era i.e. from mid-March 2020 till June 11, 2020 was collected and reviewed using Microsoft Excel sheet. Various parameters including tumour stage, type of approach, resection with/without stoma, length of hospital stay and overall complication rate were analysed. Results: Total 25 elective colorectal resections were performed. Majority (32%) had tumour in rectum, followed by sigmoid colon (28%) and caecum (16%). Laparoscopic approach was used in 16/25 cases (64%). 48% underwent anterior resection, while right hemicolectomy was performed in 36%. Stoma was fashioned in 13/25 cases (52%). Of 25, only two patients (8%) developed Covid-19 infection post-operatively, which was managed conservatively without any morbidity/mortality. Mean hospital stay was 5.7 days. 30-day mortality was zero in 17/25 patients (68%). Conclusion: Study highlights the importance of effect of COVID-19 on our routine colorectal surgical practice, providing insight into challenges faced by each member of health care team. However, we adopted new changes in our daily practice and managed to continue elective time critical resections, even in Covid pandemic without increasing the risk of morbidity/mortality. Funding Statement: None. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: This study was approved by the Colorectal department at Lutton and Dunstable University Hospital