Establishing Minimally Invasive Colorectal Unit at a Tertiary Care Indian Centre in Covid-19 Second Wave

ABSTRACT

Aim: Minimally invasive cancer surgery is the becoming the standard of care in colorectal oncology. With the growing interest in the use of tailored approach to improve the outcomes, colorectal oncology demands sub-specialised care. Method(s) This is a description of establishment of a dedicated colo-rectal oncology unit at a newly built tertiary care centre in the country, Tata Memorial Centre (Varanasi) with special emphasis on the introduction of laparoscopy for standard and extended colo-rectal surgery. Result(s) Over a period of 4 months, from February 2021 to May 2021, 35 colo-rectal surgeries have been done with 5 emergency cases and the remaining in elective setting. Operative procedures included -10 colectomies, 5 stoma/ostomy creations, 7 rectal resections in standard TME plane, 2 total pelvic exenterations, 11 extended rectal resections. 22 of these 35 surgeries (62.8%) were done using laparoscopic approach. Laparoscopy has been used across all procedures, specifically 5 colectomies, 7 standard TME rectal surgeries, 5 extended rectal resections and 1 total pelvic exenteration. Clavein dindo Grade 3 or higher morbidity was seen in 5.7% cases. Joint clinic session dedicated to colorectal oncology is conducted to provide a tailor-made individualized care to appropriate patients. Conclusion(s) Use of minimally invasive approach in colorectal oncology along with a sub specialized unit is the need of the hour to improve the outcomes in this cohort of patients.