The ‘’Super Green Pathway’’; What have we learned so far? The experience and outcomes of elective urgent and cancer surgery in a District General Hospital in the United Kingdom during Covid-19 Pandemic

BackgroundThe coronavirus disease (COVID-19) had so far claimed more than 600 000 lives worldwide. Many urgent and elective surgeries were postponed to cope with the pandemic, with the latest data found a substantial postoperative mortality risk (25.6%, 18.9%) after an emergency and elective surgery, respectively. Our institution was one of the first few in the country to offer essential elective surgery using a “COVID-free” designated site during the start of the pandemic. This study aims to analyze the clinical outcomes of patients who underwent essential elective procedures during the virus outbreak in the UK. MethodsRetrospective analysis of outcomes of all patients who had undergone urgent elective and cancer surgery, from 30th March 2020 to 21st May 2020, using an implemented “Super Green Pathway.”The primary endpoints were 30 days mortality and COVID-related morbidities, and the secondary end-points were surgically related complications and oncological outcomes. ResultsA total of 92 patients (Male: 45%; Female: 55%) across 5 surgical specialties were identified. There was no record of mortality in our cohort. Only 1 patient was tested positive for SARS-CoV-2, 18 days after the initial operation without any pulmonary complications. There were 7 postoperative surgical complications managed at the acute hospital site. The waiting time for surgery ranges from 6 to 191 days, mean of 30 days, and a median of 23 days. ConclusionIt is possible to mitigate the high mortality risk of post-operative complications associated with COVID-19, with no delay to essential surgeries for cancer patients, thus delivering safe practice during the pandemic.