Safety and efficacy of total one-day perioperative completion for inguinal hernia repair during the COVID-19 pandemic: a retrospective cohort study

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, frequent perioperative interactions between patients and medical staff increased the risk of nosocomial infections. Total 1-day perioperative completion (TODPC) involves conducting preoperative evaluations, performing the operation, and facilitating discharge within a single day. This study aimed to evaluate the safety of TODPC in reducing perioperative contact by utilizing online and telephone appointment systems for inguinal hernia (IH) repairs.

Methods: In this retrospective cohort study, we analyzed data from patients who underwent IH repairs. The study was divided into 2 periods relative to the COVID-19 pandemic: 18 months pre-pandemic (Group 1, September 2018-February 2020) and 18 months post-pandemic onset (Group 2, March 2020-August 2021). We compared the frequency of TODPC, daycare surgeries (which require hospital visits for preoperative evaluations and admission on the day of surgery), preoperative contacts, hernia types, incarcerations, organ resections, and instances of COVID-19 transmission among medical staff and patients.

Results: The study included 5,728 participants, comprising 4,614 pediatric and 1,114 adult patients. The rate of TODPC implementation was higher in Group 2 than in Group 1 (91.0% vs. 75.0%, P < 0.001). The incidence of organ resections was low and did not differ significantly between the 2 groups. Throughout the study, there were no reported nosocomial COVID-19 infections among patients, parents, caregivers, or medical staff.

Conclusion: TODPC for IH repair was a safe strategy for minimizing the need for organ resections and reducing the risk of mass COVID-19 infections during the pandemic period from March 2020 to August 2021.