Transition of general surgery procedures to outpatient settings during COVID-19

Editor's Note

This study from the Mayo Clinic finds that despite calls for the expansion of outpatient surgery to mitigate the growing backlog of surgical cases during COVID-19, the transition of general surgery procedures from inpatient to outpatient settings occurred in only a small subset of procedures.

This cohort study included 988,436 patients who underwent 16 general surgery procedures—823,746 had surgery before COVID-19 and 164,690 had surgery during COVID-19.

Multivariate analysis found that the odds of outpatient surgery during COVID-19 vs before were higher in patients having:

• mastectomy for cancer
• minimally invasive adrenalectomy
• thyroid lobectomy
• breast lumpectomy
• minimally invasive sleeve gastrectomy
• parathyroidectomy
• total thyroidectomy.

However, only four procedures had a clinically meaningful overall increase in outpatient surgery rates:

• mastectomy for cancer (+19.4%)
• thyroid lobectomy (+14.7%)
• minimally invasive ventral hernia repair (+10.6%)
• parathyroidectomy (+10.0).

Further studies should explore potential barriers to the transition to outpatient surgery, particularly for procedures that have been shown to be safely performed in an outpatient setting, the researchers note.