March 2, 2023

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

By: Judy Mathias

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.

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