Routine Elective Procedures: A Delay May Lead to Complications
28 Million Elective (Routine) Surgeries May be Cancelled or Postponed Worldwide: Reveals Study
New Delhi, 16th Dec 2020: The CovidSurg Collaborative research study based on a 12-week period of peak disruption to hospital services due to COVID-19 has predicted that around 28 million elective surgeries across the globe could be cancelled or postponed as a result of the COVID-19 pandemic – leading to patients facing a lengthy wait for their health issues to be resolved.[1] Elective surgery means routine surgery which is not in need of immediate addressal and the patient has some time to explore their treatment options.
Whatever may be the reason behind postponing the routine surgery, it can lead to complications. Patients in need of surgery should go about scheduling their procedures. It’s especially true and essential for anyone who postponed a procedure because of the COVID-19 pandemic. Common conditions like gallbladder stones, hernias or tumours often worsen and result in more complications when necessary surgery is postponed.
“Owing to COVID-19, cancelling elective surgery at a large scale will have a substantial impact on patients and cumulative, potentially devastating consequences for health systems. Delaying time-sensitive elective operations may lead to deteriorating health, worsening quality of life, and unnecessary deaths. There is a risk that delayed treatment of benign conditions as a result of pandemic-related cancellations will lead to deterioration in individual patients’ conditions, increasing disability and reducing their ability to work. In the UK, we see, 50% of surgeries are elective and 50% emergency, however in India, 80% of surgeries are done in private care wherein 90% are elective and 10% emergency.”Dr Pradeep Chowbey, Chairman, Max Institute of Minimal Access, Metabolic & Bariatric Surgery, New Delhi, India.
Adding further, Dr Chowbey said,“We have an interesting case study to share regarding the consequences of delaying the routine (elective) surgery. In the month of January 2020, a female patient Ramawati Devi (name changed), aged 76 visited our OPD first time and was diagnosed with Abdominal Hysterectomy followed by Multiple Open & Lap Hernia repair and advised for surgical repair, which she ignored. Again, she visited us in May 2020 with symptoms suggestive of obstruction in the Hernia, and she also had signs of strangulation. Stabilization was done in ICU and surgery performed. Post-surgery, the ICU stay was required further.”
“From this case study, it is evident that on account of the ongoing COVID-19 pandemic, management of non-COVID conditions should not be compromised. Especially, in many benign conditions, which can be easily managed by elective surgeries, may present with severe life-threatening complications if ignored at early stages. In this case, an uncomplicated Elective Laparoscopic Hernia Repair transformed into an emergency open repair requiring large segment bowel resection owing to unanticipated delays due to COVID-19,” added Dr Chowbey.
[1] Reference: COVID Surg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020 Oct;107(11):1440-1449. doi: 10.1002/bjs.11746. Epub 2020 Jun 13. PMID: 32395848; PMCID: PMC 7272903.
