• Surgery · Aug 2021

    Multicenter Study Comparative Study

    Reduced duration of stay after elective colorectal surgery during the peak phase of COVID-19 pandemic: A positive effect of infection risk awareness?

    • Antonino Spinelli, Michele Carvello, Francesco Maria Carrano, Francesco Pasini, Caterina Foppa, Giovanni Taffurelli, Giampaolo Ugolini, and Isacco Montroni.
    • IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Milan, Pieve Emanuele, Italy. Electronic address: antonino.spinelli@hunimed.eu.
    • Surgery. 2021 Aug 1; 170 (2): 558-562.

    BackgroundWhile elective surgery was shut down in most settings during the 2019 novel coronavirus pandemic, some referral centers were designated as surgery hubs. We sought to investigate how the pandemic scenario impacted the quality of a long-established enhanced recovery protocol colorectal surgery program in 2 referral centers, designated as colorectal surgery hubs, located in the epicentral Italian regions hardest hit by the pandemic.MethodsWe compared short-term outcomes of patients undergoing major colorectal surgery with a long-established enhanced recovery protocol during the coronavirus disease 2019 outbreak occurred in 2020 (group A) with the correspondent timeframe of 2019 (group B). Primary outcomes were morbidity and mortality, duration of stay, and readmission rate.ResultsOne hundred and thirty-six patients underwent major colorectal surgery in group A and 173 in group B. Postoperative complications and readmission rate were comparable between the 2 groups. Oncologic case-log was predominant in group A compared with group B (73.5 vs 61%; P = .01). A significantly shorter overall duration of stay was found in group A (P < .001). Uncomplicated patients of group A had a shorter duration of stay when compared with uncomplicated patients of group B (P = .008).ConclusionUnder special precautionary measures, major colorectal surgery can be undertaken on elective basis even during coronavirus disease 2019 pandemic with reasonable results. A reduction of duration of stay within a long-established enhanced recovery protocol colorectal surgery program was observed during the coronavirus disease 2019 pandemic occurred in 2020 in comparison with the correspondent timeframe of the previous year without compromising short-term outcomes. The pandemic uncovered the positive impact of patients' commitment to reducing duration of stay as the empowered risk awareness likely promoted their compliance to the enhanced recovery protocol.Copyright © 2020 Elsevier Inc. All rights reserved.

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