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. 2021 Nov;35(11):6300-6306.
doi: 10.1007/s00464-020-08130-1. Epub 2020 Nov 2.

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

María J Irarrázaval  1 , Martin Inzunza  1 , Rodrigo Muñoz  1 , Nicolás Quezada  1 , Alejandro Brañes  1 , Mauricio Gabrielli  1 , Pedro Soto  1 , Martín Dib  1 , Gonzalo Urrejola  1 , Julian Varas  1 , Sebastián Valderrama  1 , Fernando Crovari  1 , Pablo Achurra  2
Affiliations

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

María J Irarrázaval et al. Surg Endosc. 2021 Nov.

Abstract

Recent coronavirus outbreak and "stay at home" policies have accelerated the implementation of virtual healthcare. Many surgery departments are implementing telemedicine to enhance remote perioperative care. However, concern still arises regarding the safety of this modality in postoperative follow-up after gastrointestinal surgery. The aim of the present prospective study is to compare the use of telemedicine clinics to in-person follow-up for postoperative care after gastrointestinal surgery during COVID-19 outbreak.

Methods: Prospective study that included all abdominal surgery patients operated since the COVID-19 outbreak. On discharge, patients were given the option to perform their postoperative follow-up appointment by telemedicine or by in-person clinics. Demographic, perioperative, and follow-up variables were analyzed.

Results: Among 219 patients who underwent abdominal surgery, 106 (48%) had their postoperative follow-up using telemedicine. There were no differences in age, gender, ASA score, and COVID-19 positive rate between groups. Patients who preferred telemedicine over in-person follow-up were more likely to have undergone laparoscopic surgery (71% vs. 51%, P = 0.037) and emergency surgery (55% vs. 41%; P = 0.038). Morbidity rate for telemedicine and in-person group was 5.7% and 8%, (P = 0.50). Only 2.8% of patients needed an in-person visit following the telemedicine consult, and 1.9% visited the emergency department.

Conclusions: In the current pandemic, telemedicine follow-up can be safely and effectively performed in selected surgical patients. Patients who underwent laparoscopic and emergency procedures opted more for telemedicine than in-person follow-up.

Keywords: COVID-19 pandemic; Postoperative care; Telemedicine.

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Conflict of interest statement

Drs. María J. Irarrázaval, Martin Inzunza, Rodrigo Muñoz, Nicolás Quezada, Alejandro Brañes, Mauricio Gabrielli, Pedro Soto, Martin Dib, Gonzalo Urrejola, Julian Varas, Sebastián Valderrama, Fernando Crovari and Pablo Achurra have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Eligible patients for analysis. A total of 219 patients were included for analysis: 106 had a telemedicine postoperative visit and 113 an in-person consult
Fig. 2
Fig. 2
Type of surgical procedures. There was no difference between telemedicine and in-person groups when comparing the rate of patients who underwent gastroesophageal, hepatobiliary, colorectal and general surgery procedures (15% vs 10%, 7% vs 13%, 15% vs 29% and 62% vs 48%, respectively; P = 0.18)
Fig. 3
Fig. 3
Evolution in time of telemedicine and in-person visits. During week 1, 25% of patients had telemedicine consults; and during week 14, 80% of patients. There were two waves of COVID-19 in our country, the first one during week 1 and the second during week 6 of our study
See this image and copyright information in PMC

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