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

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes
• Healthcare Management

Background:

• COVID-19 pandemic significantly impacted healthcare systems, necessitating innovative protocols for elective surgeries.
• A Same Day Surgery (SDS) protocol was implemented for foregut surgeries to optimize resource utilization during the pandemic.
• Foregut surgeries included hiatal hernia repair, paraesophageal hernia repair, Heller myotomy, and fundoplication.

Purpose of the Study:

• To evaluate the safety and efficacy of a Same Day Surgery (SDS) protocol for elective foregut surgeries.
• To compare patient outcomes between a pre-pandemic cohort (standard overnight admission) and a pandemic cohort (SDS discharge).
• To assess the impact of the SDS protocol on resource utilization and patient safety metrics.

Main Methods:

• Retrospective review of patients undergoing elective laparoscopic foregut surgery.
• Comparison of a pre-pandemic cohort (August 2019 - April 2020) with a pandemic cohort (August 2020 - January 2022).
• Analysis of 30-day emergency department visit rates and readmission rates between the two cohorts.

Main Results:

• 41 patients were discharged Same Day Surgery (SDS) under the pandemic protocol, compared to 36 patients in the pre-pandemic cohort.
• No statistically significant difference was found in 30-day emergency department visit rates (p=0.4557).
• No statistically significant difference was observed in 30-day readmission rates (p=0.6790).

Conclusions:

• Implementation of a Same Day Surgery (SDS) protocol for foregut surgery is a safe approach.
• This protocol allows for the delivery of essential surgical care while reducing healthcare resource utilization.
• The SDS protocol for foregut surgery demonstrates comparable safety outcomes to traditional overnight admission practices.