EP.WE.127Outcomes of colorectal cancer resections performed within Modified Enhanced Recovery After Surgery (M-ERAS) pathway during the first peak of COVID-19 pandemic

Abstract

Aim: Enhanced Recovery After Surgery (ERAS) pathway has shown to reduce pulmonary complications and length of stay (LoS). However, the impact of pandemic on the care of patients in the ERAS pathway is unknown. Certain ERAS elements (i.e. Laparoscopic surgery) were considered un-safe at the outset of the current pandemic and therefore avoided. We present our experience of implementation of Modified ERAS (M-ERAS) pathway in a small cohort of colorectal cancer resections performed in our hospital during the first peak of the pandemic. Method(s): We analysed all colorectal cancer resections performed from 11th March to 31st June 2020 in our hospital. Those who admitted via emergency pathway and managed outside M-ERAS were excluded from the analysis. Primary outcome measures were LOS, pulmonary complications and 30-day mortality rate. Secondary outcome measures were short term complications (including post-op SARS-CoV-2 infections) and 30-day re-admission rate. Result(s): All resections were performed in a non-COVID light setting (i.e. acute hospital). We performed 8 elective resections during the pandemic and 1 of them managed outside M-ERAS. All resections were performed via open access. All tumours were locally advanced (T3 and above) and one patient had neo-adjuvant chemotherapy. Two patients had metastatic disease. Average LOS was 8.1 day. One patent developed post-operative minor pulmonary embolism and required re-admission within 30 days post op. There was no 30-day mortality. Conclusion(s): Implementation of M-ERAS elements may be COVID safe. More robust data are required to ascertain the safety and efficacy of ERAS/M-ERAS pathway in COVID risk ambience.