Tan Tock Seng Hospital1
During the COVID-19 pandemic, elective surgical workload has reduced to mitigate viral transmission during surgery and redistribute manpower to meet needs of patients with COVID-19. We aim to evaluate the impact of the pandemic on perioperative outcomes following colorectal surgery and compliance to ERAS protocols.
A retrospective study of patients who underwent colorectal surgery during the COVID-19 pandemic between 7 February to 30 July 2020 as compared to a similar 6-month period between 7 February to 30 July 2019 was carried out.
A total of 87 patients underwent surgery in 2020 as compared to 102 during the same 6-month period in 2019. There were comparable rectal and colonic operations, p>0.05. Operative time was significantly longer, 314 (244-441) minutes in the COVID-19 period vs 241 (181-343) minutes in the pre-COVID-19 period, p=0.001. ERAS compliance rates were 68.3% in COVID-19 period and 72.6% in pre-COVID-19 period, p>0.05. Time to pain control with postoperative analgesia was longer for patients in the COVID-19 period, 3 (2-5) days vs 1 (0-4) day, p=0.003. There were more Clavien-Dindo I-II complications in the COVID-19 period 43/87 (49.4%) as compared to pre-COVID-19 period, 29/102 (28.4%), p=0.003. Clavien-Dindo III-IV complications were comparable in both groups (p=0.343).
Elective colorectal resections were reduced by 15% during the COVID-19 pandemic. Redeployment of surgical manpower meant that ERAS practices were disrupted. ERAS plays an even more important role during the pandemic, to reduce postoperative complications and length of stay. Methods in empowering patients in their recovery maybe the way forward in this pandemic.