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01-11-2021 | Telemedicine

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

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

Published in: Surgical Endoscopy | Issue 11/2021

Abstract

Summary and background data

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.

Williams AM, Bhatti UF, Alam HB, Nikolian VC (2018) The role of telemedicine in postoperative care. Mhealth 4:11. https://doi.org/10.21037/mhealth.2018.04.03CrossRefPubMedPubMedCentral

Hong Z, Li N, Li D, Li J, Li B, Xiong W et al (2020) Telemedicine during the COVID-19 pandemic: experiences from Western China. J Med Internet Res 22(5):e19577. https://doi.org/10.2196/19577CrossRefPubMedPubMedCentral

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX et al (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382(18):1708–1720. https://doi.org/10.1056/NEJMoa2002032CrossRef

Smith WR, Atala AJ, Terlecki RP, Kelly EE, Matthews CA (2020) Implementation guide for rapid integration of an outpatient telemedicine program during the COVID-19 pandemic. J Am Coll Surg. https://doi.org/10.1016/j.jamcollsurg.2020.04.030CrossRefPubMedPubMedCentral

Palomba G, Dinuzzi VP, De Palma GD, Aprea G (2020) Management strategies and role of telemedicine in a surgery unit during COVID-19 outbreak. Int J Surg 79:189–190. https://doi.org/10.1016/j.ijsu.2020.05.081CrossRefPubMedPubMedCentral

Nikolian VC, Williams AM, Jacobs BN, Kemp MT, Wilson JK, Mulholland MW et al (2018) Pilot study to evaluate the safety, feasibility, and financial implications of a postoperative telemedicine program. Ann Surg 268(4):700–707. https://doi.org/10.1097/SLA.0000000000002931CrossRefPubMed

Gunter RL, Chouinard S, Fernandes-Taylor S, Wiseman JT, Clarkson S, Bennett K et al (2016) Current use of telemedicine for post-discharge surgical care: a systematic review. J Am Coll Surg 222(5):915–927. https://doi.org/10.1016/j.jamcollsurg.2016.01.062CrossRefPubMedPubMedCentral

Robbins T, Hudson S, Ray P, Sankar S, Patel K, Randeva H et al (2020) COVID-19: a new digital dawn? Digit Health 6:2055207620920083. https://doi.org/10.1177/2055207620920083CrossRefPubMedPubMedCentral

Sorensen MJ, Bessen S, Danford J, Fleischer C, Wong SL (2020) Telemedicine for surgical consultations—pandemic response or here to stay?: A report of public perceptions. Ann Surg. https://doi.org/10.1097/SLA.0000000000004125CrossRefPubMed

10.

Segura-Sampedro JJ, Rivero-Belenchón I, Pino-Díaz V, Rodríguez Sánchez MC, Pareja-Ciuró F, Padillo-Ruiz J et al (2017) Feasibility and safety of surgical wound remote follow-up by smart phone in appendectomy: a pilot study. Ann Med Surg (Lond) 21:58–62. https://doi.org/10.1016/j.amsu.2017.07.040CrossRef

11.

Bednarski BK, Slack RS, Katz M, You YN, Papadopolous J, Rodriguez-Bigas MA et al (2018) Assessment of ileostomy output using telemedicine: a feasibility trial. Dis Colon Rectum 61(1):77–83. https://doi.org/10.1097/DCR.0000000000000945CrossRefPubMed

12.

Hwa K, Wren SM (2013) Telehealth follow-up in lieu of postoperative clinic visit for ambulatory surgery: results of a pilot program. JAMA Surg 148(9):823–827. https://doi.org/10.1001/jamasurg.2013.2672CrossRefPubMed

13.

Viers BR, Lightner DJ, Rivera ME, Tollefson MK, Boorjian SA, Karnes RJ et al (2015) Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: a randomized controlled trial. Eur Urol 68(4):729–735. https://doi.org/10.1016/j.eururo.2015.04.002CrossRefPubMed

14.

Urquhart AC, Antoniotti NM, Berg RL (2011) Telemedicine—an efficient and cost-effective approach in parathyroid surgery. Laryngoscope 121(7):1422–1425. https://doi.org/10.1002/lary.21812CrossRefPubMed

15.

Costa MA, Yao CA, Gillenwater TJ, Taghva GH, Abrishami S, Green TA et al (2015) Telemedicine in cleft care: reliability and predictability in regional and international practice settings. J Craniofac Surg 26(4):1116–1120. https://doi.org/10.1097/SCS.0000000000001560CrossRefPubMed

16.

Cremades M, Ferret G, Parés D, Navinés J, Espin F, Pardo F et al (2020) Telemedicine to follow patients in a general surgery department. A randomized controlled trial. Am J Surg. 219(6):882–7. https://doi.org/10.1016/j.amjsurg.2020.03.023CrossRefPubMed

17.

Kummerow Broman K, Roumie CL, Stewart MK, Castellanos JA, Tarpley JL, Dittus RS et al (2016) Implementation of a telephone postoperative clinic in an integrated health system. J Am Coll Surg 223(4):644–651. https://doi.org/10.1016/j.jamcollsurg.2016.07.010CrossRefPubMed

18.

Canon S, Shera A, Patel A, Zamilpa I, Paddack J, Fisher PL et al (2014) A pilot study of telemedicine for post-operative urological care in children. J Telemed Telecare 20(8):427–430. https://doi.org/10.1177/1357633X14555610CrossRefPubMed

Title: Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic
Authors: María J. Irarrázaval
Martin Inzunza
Rodrigo Muñoz
Nicolás Quezada
Alejandro Brañes
Mauricio Gabrielli
Pedro Soto
Martín Dib
Gonzalo Urrejola
Julian Varas
Sebastián Valderrama
Fernando Crovari
Pablo Achurra
Publication date: 01-11-2021
Publisher: Springer US
Keywords: Telemedicine
COVID-19
Published in: Surgical Endoscopy / Issue 11/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-08130-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Summary and background data

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary and background data

Methods

Results

Conclusions

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