Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour
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ORIGINAL ARTICLE
Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour Vivek Sukumar 1 & Diwakar Pandey 1 & Barath Raj Kumar 1 & Swapnil Patel 1 & Tushar Pawar 1 & Jitender Rohila 1 & Ashwin DeSouza 1 & Avanish Saklani 1 Received: 19 June 2020 / Accepted: 21 September 2020 # Indian Association of Surgical Oncology 2020
Abstract The health services across the world have been deeply impacted by the ongoing COVID-19 pandemic which has resulted in diversion of resources to testing, isolating and treating COVID-19 patients. This meant cutting down resources and manpower away of various healthcare facilities and severely hampering the functioning of various cancer services across the world. It is however, important to understand, cancer itself is a life-threatening condition, and there is a need to continue running cancer care services, at least for those who needed the most. Various clinical societies have put forward guidelines and protocols to help continue surgical services during the pandemic. The role of minimally invasive surgery (MIS) was initially questioned at the start of the pandemic, however gradually increasing evidence favored MIS as it reduced hospital stay and complication. Enhanced recovery programs which have been introduced to various fields of surgery to improve outcomes and reduce hospital stay. It plays an essential role in times like this, where the optimal usage of minimal resources is essential. We embraced these methods to ensure safety of our patients and staff and at the same time provide the highest standards of care. Here we are presenting our experience of running a colorectal surgical unit during these difficult times with emphasis on promotion of minimally invasive surgery, at the epicenter of the pandemic in India. Keywords COVID 19 . Minimally invasive surgery . Colorectal surgery . Outcomes
Introduction The COVID-19 pandemic has impacted healthcare services around the world presenting with challenges to provide essential healthcare services. A recent survey of the WHO, which was conducted in 155 countries over a 3-week period in May, confirmed 42% of countries reporting partial or complete disruption of services for cancer treatment [1]. At the onset of the pandemic, various clinical societies across the world released guidelines to facilitate optimum delivery of healthcare in resource constrained settings taking cognizance of the risks faced by the healthcare providers. There is a need to incorporate and strictly enforce various strategies such as enhanced recovery programs which have demonstrated to lower
* Avanish Saklani [email protected] 1
Division of Colorectal and Peritoneal Surface Oncology, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Dr Ernest Borges Street, Parel, Mumbai 400012, India
recovery time and post-operative complication rates, helping us to optimally utilize the minimum available resources without burdening the already strained health care infrastructure [3].
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