Reduced length of stay after elective colorectal surgery during the peak phase of Covid-19 pandemic: a positive effect of infection risk awareness?

Abstract Background While during the Covid-19 pandemic elective surgery was shut-down of in most settings, some referral centers were designated as surgery hubs. We sought to investigate how the pandemic scenario has ve impacted the quality of a long-established enhanced recovery protocol (ERP) colorectal surgery (CRS) program in two referral center, designated as colorectal surgery hub, located in the epicentral Italian regions hardest hit by the pandemic. Methods We have compared short-term outcomes of patients undergoing major colorectal surgery with a long-established ERP during the COVID-19 outbreak (group A) with the correspondent timeframe of 2019 (group B). Primary outcomes were morbidity and mortality, LOS, and readmission rate. Results Hundred and thirty-six patients underwent major colorectal surgery in group A and 173 in group B. Post-operative complications and readmission rate were comparable between the two groups. Oncologic case-log was predominant in group A comparing with group B (73.5 vs 61%, p=0.01). A significantly shorter overall LOS was found in group A (p Conclusion Under special precautionary measures, major CRS can be undertaken on elective basis even during the COVID-19 pandemic with reasonable results. A reduction of LOS, within a long-established ERP-CRS program, was observed during the Covid-19 pandemic in comparison with the correspondent timeframe of 2019 without compromising short term outcomes. The pandemic uncovered the positive impact of patients’ commitment to reducing LOS as the empowered risk awareness likely promoted their compliance to ERP.