TU3.5 Increasing stoma requirements during the COVID-19 pandemic

Abstract

Aims The COVID-19 pandemic has led to a change in working practices in the diagnosis and management of colorectal cancer. Guidelines emerged which recommended changing anastomotic practice in favour of forming a defunctioning stoma or end stoma in patients who would have previously had an anastomosis. This study aimed to identify whether these changes have resulted in an increase in patients requiring a stoma and its potential impact. Methods All patients diagnosed with colorectal cancer in the authors’ tertiary surgical unit in three 4-month intervals were included. These corresponded to before the pandemic (March–June 2019), during the UK's first wave of COVID-19 (March–June 2020), and during the second wave (December 2020–March 2021). The incidence of stomas was compared between groups. Results In patients undergoing elective surgery the incidence of stomas was 13% pre-pandemic. However, this tripled to 39% during the first wave and increased to 54% in the second wave. Similar trends were seen in patients undergoing emergency surgery with 36% having stomas before the pandemic which rose to 50% during both the waves. Conclusion A change in stoma practice was observed with patients having a stoma when they would usually have had an anastomosis only. As COVID-19 continues to have a severe effect on planned surgery in the UK, patients requiring stoma reversal adds to the backlog. As the huge task of clearing the backlog begins, surgical teams must be provided with appropriate resources, professional and mental health support.