A fast tract to foregut surgery: Pandemic-driven protocol development

Am J Surg. 2023 Mar;225(3):481-484. doi: 10.1016/j.amjsurg.2023.01.006. Epub 2023 Jan 7.

Abstract

Background: COVID-19 has overwhelmed many health care systems which has affected the landscape of elective surgery. A pandemic driven protocol was developed to perform foregut surgeries as a Same Day Surgery (SDS) discharge for all comers to reduce resource utilization.

Methods: Retrospective review of all patients who underwent elective laparoscopic foregut surgery (hiatal hernia, paraesophageal hernia, heller myotomy, and fundoplication) from 8/1/2020-1/31/2022 by a single surgeon after the implementation of a SDS protocol. Patients were compared to a pre-pandemic cohort, from 8/1/2019-4/30/2020, when overnight admission was standard practice.

Results: There were 36 pre-pandemic patients, and 41 pandemic patients successfully discharged the same day of surgery. We failed to detect a statistically significant difference between the two groups regarding 30-day ED visit rate (p-value of 0.4557) and 30-day readmission rate (p-value of 0.6790).

Conclusion: The creation of a SDS protocol for foregut surgery is a safe way to deliver much needed care to the community while decreasing resource utilization.

Keywords: COVID-19; Coronavirus; Foregut surgery; Hiatal hernia; Outpatient surgery.

MeSH terms

  • COVID-19* / epidemiology
  • Fundoplication / methods
  • Hernia, Hiatal* / surgery
  • Humans
  • Laparoscopy* / methods
  • Pandemics
  • Retrospective Studies
  • Treatment Outcome