SP4.2.4 Single centre experience of ‘Green Zone’ elective general surgery after the first wave of COVID-19

Abstract Introduction Elective surgery came to a halt during the first wave of COVID-19. The safe resumption of elective surgery with COVID-19 prevalent in the community, remains a significant challenge. The aim of this study was to look into the outcomes of elective general surgery in a dedicated ‘Green Zone’ following the first wave of COVID-19. Methods A ‘Green Zone’ pathway was drafted which was meant to provide a COVID-free environment for patients. Prospective data was collected on consecutive patients who underwent elective general surgical procedure at a single NHS trust over a 10-week period (1st Sept 2020 - 10th Nov 2020). The primary outcome was 30-day COVID-19 mortality. Secondary outcomes included 30-day nonCOVID-19 mortality, readmissions and complications. Results The study included 185 patients with a median age 55 years (IQR 41-67); 96 (52%) were females. Majority of the patients were ASA 2 (n = 98, 53%) followed by equal number of ASA 1 and ASA 3 (n = 42, 23%). 33 patients (18%) had been shielding earlier in the year. 96% underwent general anaesthetic. Most of the cases were day cases (n = 131, 71%). There was no 30-day COVID-19 or nonCOVID-19 mortality. One patient developed COVID-19 three weeks after the index operation. 30-day readmission and complication rate were 5% (n = 10) and 10% (n = 18). Most of the complications were Clavien-Dindo grade 1(n = 8, 4%) and 2(n = 8, 4%). Conclusion This study has shown that dedicated ‘Green Zone’ elective operating pathway is safe provided a balanced risk assessment approach is adopted.

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755 Elective Surgery in the COVID-19 Pandemic: Outcomes of 100 Consecutive Cases

British Journal of Surgery ◽

10.1093/bjs/znab134.083 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Fisher ◽

C Hadjittofi ◽

Z Ali ◽

P Antonas ◽

K Parekh ◽

...

Keyword(s):

Pain Management ◽

Oral Surgery ◽

Elective Surgery ◽

University Hospital ◽

Single Centre ◽

Median Length ◽

Microsoft Excel ◽

Single Centre Study ◽

Green Zone

Abstract Introduction The COVID-19 pandemic halted elective surgical activity. Basildon University Hospital established an elective Green Zone for COVID-19 swab negative patients who isolated for 14 days. This study reviewed the outcomes of the first 100 patients. Method A single-centre study was performed. Demographic and perioperative electronic data were supplemented with telephone follow-up for the first 100 Green Zone patients and analysed in Microsoft Excel. Results One hundred Green Zone patients underwent surgery between 21/05/2020 and 16/06/2020. The median age was 55 (14-88) years. 52% were female. Their operations were performed by General Surgery (39%), Gynaecology (17%), Vascular Surgery (14%), Oral Surgery (12%), ENT (9%), Urology (8%), and Pain Management (1%). Preoperatively, 100% had a negative SARS-CoV-2 swab and one had CT evidence of mild resolving COVID-19. Two patients had postoperative SARS-CoV-2 swabs, both negative. Median length of stay was 0 (0-7) days. 84% responded to telephone follow-up at a median 25 (13-54) postoperative days, 69% of whom were asymptomatic There were no 30-day major complications (>Clavien-Dindo IIIa) or 90-day mortality. Conclusions Elective surgery can be safe during the COVID-19 pandemic, with appropriate measures in place. This has significant implications in the context of an ever-expanding NHS waiting list during a pandemic of uncertain duration.

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907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

British Journal of Surgery ◽

10.1093/bjs/znab134.096 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

T Crotty ◽

M Corbett ◽

T Hussain ◽

A Diaconescu ◽

N Patil

Keyword(s):

Patient Satisfaction ◽

Prospective Study ◽

Local Anaesthetic ◽

Regional Anaesthesia ◽

Effective Alternative ◽

General Anaesthetic ◽

Single Centre ◽

Pain Scores ◽

Single Centre Experience ◽

Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

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Metabolic outcomes in patients with diabetes mellitus administered SGLT2 inhibitors immediately before emergency or elective surgery: single centre experience and recommendations

British Journal of Anaesthesia ◽

10.1016/j.bja.2021.03.023 ◽

2021 ◽

Author(s):

Ray Wang ◽

Benjamin Kave ◽

Edward McIlroy ◽

Mervyn Kyi ◽

Peter G. Colman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Elective Surgery ◽

Sglt2 Inhibitors ◽

Single Centre ◽

Metabolic Outcomes ◽

Single Centre Experience ◽

Patients With Diabetes

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The impact of COVID-19 on emergency general surgery admissions and operative volumes: A single centre experience

The Surgeon ◽

10.1016/j.surge.2020.09.013 ◽

2020 ◽

Author(s):

R.M. O'Connell ◽

M.A. Khan ◽

M. Amir ◽

M. Bucheeri ◽

W. Khan ◽

...

Keyword(s):

General Surgery ◽

Single Centre ◽

Emergency General Surgery ◽

Single Centre Experience ◽

The Impact

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Role of a dedicated referral system for patients with liver disease and potential indication for liver transplantation: prospective data from a single centre experience

Digestive and Liver Disease ◽

10.1016/j.dld.2019.12.091 ◽

2020 ◽

Vol 52 ◽

pp. e70-e71

Author(s):

G. Germani ◽

A. Ferrarese ◽

F.P. Russo ◽

M. Senzolo ◽

M. Gambato ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Referral System ◽

Single Centre ◽

Prospective Data ◽

Single Centre Experience

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Thyroidectomy: is it safe to be performed by general surgery residents? – single centre experience

Acta Chirurgica Belgica ◽

10.1080/00015458.2021.1979185 ◽

2021 ◽

pp. 1-6

Author(s):

Magdalena Pisarska-Adamczyk ◽

Piotr Tylec ◽

Natalia Przytuła ◽

Julia Wierzbicka ◽

Michał Wysocki ◽

...

Keyword(s):

General Surgery ◽

Single Centre ◽

Single Centre Experience

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SP4.2.3 Single centre concept of ‘cold site’ elective surgery during the peak of COVID-19 pandemic: a cohort study

British Journal of Surgery ◽

10.1093/bjs/znab361.099 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Muhammad Rafaih Iqbal ◽

Adeel Abbas Dhahri ◽

Nourelhuda Mohammed Mustafa Darwish ◽

Vardhini Vijay

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Postoperative Period ◽

Primary Outcome ◽

Private Hospital ◽

Elective Surgery ◽

Healthcare Systems ◽

Single Centre ◽

Secondary Outcomes ◽

Related Mortality

Abstract Objective The COVID-19 pandemic caused a major strain on healthcare systems across the globe. As these systems got overwhelmed with the emergency care of the infected patients, widespread cancellations of elective surgery occurred. Our hospital utilised local private hospital as a dedicated cold site (CS) for urgent elective surgery during the peak of the COVID-19 pandemic. We aim to analyse the outcomes at this dedicated cold site. Method A retrospective review of a prospectively maintained database of all the cases operated at the CS during a 2-month period (30 March 2020 to 29 May 2020) was carried out. The primary outcome was 30-day COVID-19 related mortality. The secondary outcomes were 30-day non-COVID-19 related mortality, complications, readmission and development of COVID-19 symptoms. Results A total of 153 patients were operated on at the CS over the study period with a median age of 57 years (Interquartile range, IQR 47 – 70). 62% were females and 82% had a Body Mass Index (BMI) less than 30. 73% of the operations were performed for cancer. 59% of the surgeries were graded as intermediate and 26% as major or complex. There was no mortality at 30 days from COVID-19 or non COVID-19 causes. There was only 1 (0.65%) readmission. 7 patients (4.57%) developed complications. 1 (0.65%) patient was diagnosed with COVID-19 in the postoperative period while 3 had COVID-19 symptoms but were tested negative. Conclusion Urgent elective surgery is safe and feasible during the COVID-19 pandemic if a dedicated cold site is available.

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