The quest for safe surgery during covid-19: Feasible and rewarding

Introduction: The Covid-19 pandemic caused widespread disruption to UK colorectal cancer units. New ways of working and hastily arranged pathways for safe elective cancer surgery were initiated at many hospitals. Our health board set up a new model and green pathway, at a separate non-acute hospital to ensure that colorectal cancer surgery could continue. None of the surgeons had previously operated in this new environment and ACPGBI/RCS guidelines were followed. This study aims to assess the outcomes of cancer surgery performed during the pandemic in the new setting. Methods: An audit of all colorectal cancers resected from 28/4 to 31/8/20 during the Covid-19 pandemic. Patient outcomes were assessed for a month following operation, from the prospectively maintained colorectal departmental database. Results: No patients were declined surgery if felt appropriate by the MDT. 56 patients had surgery in the new pathway. Laparoscopic surgery was completed in 37% and 54% had stoma formation. Colorectal trainees were present in each case. Over the course of 4 months, no patients tested positive for Covid-19 following their operation. The complication rate was low with average length of stay being 8 days. One patient required a return to theatre and 5 were re-admitted in the month following discharge. Conclusion: This highly successful programme, demonstrates safe cancer surgery despite the first wave of the global pandemic and the upheaval it caused for services. This study shows that patients had successful cancer surgery in a new but safe environment. We are proud of our team's efforts.