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Impact of Coronavirus Disease 2019 on Clinical Outcomes of Robotic Cholecystectomy
Omar Yusef Kudsi1,2, Georges Kaoukabani1, Alexander Friedman3
1Department of Surgery, Good Samaritan Medical Center, Brockton.
Insights
The COVID-19 pandemic increased emergent robotic cholecystectomies (RC) and same-day discharges. However, patient outcomes and complication rates for RC remained unaffected during this period.
Area of Science:
- Minimally Invasive Surgery
- Surgical Outcomes
- Public Health Crises
Background:
- The COVID-19 pandemic significantly impacted healthcare systems globally.
- Surgical departments faced unprecedented challenges and resource constraints.
- This study investigates the effect of the pandemic on robotic cholecystectomy (RC) patient outcomes.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on patients undergoing robotic cholecystectomy (RC).
- To compare pre-pandemic and pandemic-era outcomes for RC procedures.
Main Methods:
- A retrospective study comparing patients who underwent RC one year before and after March 2020.
- Patients were divided into pre-COVID and post-COVID groups.
- Pre-, intra-, and postoperative variables were analyzed and compared between the two groups.
Main Results:
- The post-COVID group (80 patients) showed a higher rate of emergent RCs compared to the pre-COVID group (110 patients) (62.5% vs 39.1%).
- Operative times increased in the post-COVID group due to fellow participation.
- Despite increased emergent cases, complication rates were comparable, and same-day discharge rates were higher in the post-COVID group (57.5% vs 40.9%).
Conclusions:
- The COVID-19 pandemic led to an increase in emergent robotic cholecystectomies and same-day discharges.
- No significant impact on postoperative outcomes or complication rates was observed for patients undergoing RC during the pandemic.
- Robotic cholecystectomy remains a safe and effective procedure even amidst healthcare system strains caused by pandemics.
Background:
The coronavirus disease 2019 (COVID-19) pandemic strained the health care sector, putting severe constraints on surgical departments. In this study, we evaluate the impact of the pandemic on the outcomes of patients undergoing robotic cholecystectomy (RC).
Patients And Methods:
Patients who underwent RC 1 year before and after March 2020 were included in this retrospective study and assigned accordingly to the pre or post-COVID group. Pre, intra, and postoperative variables were compared between groups.
Results:
In total, 110 patients were assigned to the pre-COVID group versus 80 in the post-COVID group. There were no differences in the demographics, except for a higher rate of previous gallbladder disease in the pre-COVID group (35.5% vs 13.8,% P < 0.001). The post-COVID group had a higher rate of emergent RCs (62.5% vs 39.1%, P = 0.002). Operative times were greater in the post-COVID group due to the more frequent participation of clinical fellows in the cases. The median hospital length of stay for both groups was 1 day, with higher rates of same-day discharge (pre-COVID 40.9% vs post-COVID 57.5%, P = 0.028). Complications were comparable between both groups, with no recorded cases of COVID-19 contraction within the virus incubation period. The median follow-up was 10 months for the entire cohort.
Conclusion:
During the COVID-19 pandemic, an increase in emergent cases, as well as higher rates of same-day discharge, were recorded, with no impact on postoperative outcomes in patients undergoing RC.
