EP.WE.67 Management of Acute Appendicitis during the Early phase of the COVID-19 Pandemic: a Single NHS Centre Study

AIMS: During the early phase of the COVID-19 pandemic, general surgeons were advised to apply conservative management/open surgery for appendicitis.

This single NHS centre study has explored the resulted management differences.

METHODS: Retrospective study covering prepandemic data over (March-May, 2019) & early pandemic data over (March-May, 2020).

RESULTS: Prepandemic data (43 patients): The mean age was 38.3 years.

The mean length of stay was 1.7 days.

Preoperative imaging was used in 32(74.4%) patients; this was diagnostic in 28(87.5%).

Non-surgical management was used in 4(9.3%) patients; one needed surgery eventually.

Surgical approaches in 40 patients were (laparoscopic: 38(95%), open: 2(5%)).

Neither significant morbidity nor mortality was reported.

Early pandemic data (35 patients): The mean age was 31.2 years.

The mean length of stay was 2.2 days.

Preoperative imaging was used in 30(85.7%) patients; this was diagnostic in 26(86.6%).

Non-surgical management was used in 8(22.9%) patients; one needed surgery eventually.

Surgical approaches in 28 patients were (laparoscopic: 10(35.7%), open: 18(64.3%)).

Neither significant morbidity nor mortality was reported, apart from one patient with COVID-19 postoperative infection.

CONCLUSIONS: There was a tendency towards applying a conservative approach/open surgery during the early days of the pandemic.

Though this was statistically significant (p<0.05), the total number of patients was small to achieve statistically stronger conclusions.

Laparoscopy was selectively used during the early days of the pandemic where the benefit outweighed the risks.