ABSTRACT
Purpose/Background: Impact of the COVID-19 pandemic on medical practice has been often reported from Western countries, but there have been few studies in other areas especially regarding stoma surgery and stoma care. Hypothesis/Aim: We examined COVID-19-induced changes in stoma-related surgery and stoma management in Japan. Methods/Interventions: We investigated the numbers of all operations and stoma-related surgeries in our hospital in 2019 and 2020. The cumulative numbers of consultations at our ostomy clinic and patient population stratified by the period of having a stoma were compared between these calendar years. The frequency of ostomy clinic visit by individual patients within a year after stoma creation, and stoma-related complications per consultation were also analyzed. Results/Outcome(s): The number of elective surgery decreased by approximately 10% from 2019 to 2020, but the numbers of stoma creation and closure did not change. The total numbers of consultations at our ostomy clinic were also similar between these years. However, the percentage of patients with a stoma for less than a year who attended our ostomy clinic increased from 49.7% in 2019 to 53.5% in 2020, whereas other patients showed the opposite tendency. Moreover, patients with a stoma for less than a year visited ostomy clinic more frequently in 2020 (0.42/month) than in 2019 (0.30/month, p=0.032), as shown in Figure a. Grade 2 or severer peristomal complication per consultation decreased from 17% in 2019 to 11% in 2020 (11%) than in 2019 (p<0.001), as shown in Figure b. Limitations: Our situation may not represent the totality of hospitals in Japan. In addition, early postoperative care on the ward before discharge was not counted. There may be several patients too ill to visit our ostomy clinic. As stoma conditions at home were not assessed and follow-up intervals depended on individuals, the complication rates reported here may contain biases. Finally, we did not evaluate quality of life of stoma patients in relation to stoma-related complications, e.g. using questionnaires. Conclusions/Discussion: The COVID-19 outbreak has driven the shift in patient population at ostomy clinic to new stoma patients, which may have led to in a fewer peristomal complication at least in our hospital. Crises sometimes drive innovative methods in healthcare;for example in addition to the current clinic activity, online remote consultation of stoma care may function as a triage for face-to-face outpatient clinics and add a lot of advantages in terms of saving time and reducing healthcare costs. (Figure Presented).