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新型冠状病毒肺炎大流行对小儿泌尿外科手术活动的影响:根据Clavien-Dindo分类法分析术后并发症

Impact of the COVID-19 pandemic on the surgical activity of Pediatric Urology: analysis of postoperative complications according to the Clavien-Dindo classification.

作者信息

Merino-Mateo L, Tordable Ojeda C, Cabezalí Barbancho D, Gómez Fraile A

机构信息

Servicio de Cirugía Pediátrica. Hospital Universitario 12 de Octubre, Madrid, España.

Servicio de Cirugía Pediátrica. Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Actas Urol Esp (Engl Ed). 2020 Dec;44(10):659-664. doi: 10.1016/j.acuro.2020.09.003. Epub 2020 Sep 17.

Abstract

INTRODUCTION AND OBJECTIVE

The coronavirus disease 2019 (COVID-19) has caused a pandemic of global impact that forced social-political measures to be taken, such as the declaration of the state of alarm in Spain. At the same time, the reorganization of the pediatric medical-surgical activities and infrastructures was carried out, with the consequent suspension of the non-urgent surgical activity of Pediatric Urology. We analyzed the impact of the COVID-19 pandemic on surgical activity in a Pediatric Urology division, as well as surgical complications according to the Clavien-Dindo classification.

MATERIALS AND METHODS

A systematic review of epidemiological, clinical and surgical data was carried out, including complications and readmissions of all patients operated on in the division of Pediatric Urology within the duration of the state of alarm. Five time periods have been created according to the de-escalation phases.

RESULTS

Forty-nine surgical procedures were carried out on 45 patients (8 prior to the implementation of the de-escalation phases). High priority pathologies were the most frequent in the first phases, being the ureteropelvic junction (UPJ) obstruction the most prevalent. Four complications were recorded (8.8%), none of them were respiratory.

CONCLUSIONS

The EAU recommendations for the resumption of surgical activity have allowed a correct, safe and gradual transition to the routine surgical activity in Pediatric Urology. The Clavien-Dindo classification is useful and valid for application in this division. No respiratory complications have been reported that could be attributable to the pandemic situation.

摘要

引言与目的

2019年冠状病毒病(COVID-19)引发了一场具有全球影响的大流行,迫使各国采取社会政治措施,比如西班牙宣布进入警戒状态。与此同时,儿科医疗手术活动和基础设施进行了重组,小儿泌尿外科的非紧急手术活动随之暂停。我们分析了COVID-19大流行对小儿泌尿外科手术活动的影响,以及根据Clavien-Dindo分类法统计的手术并发症情况。

材料与方法

对流行病学、临床和手术数据进行了系统回顾,包括在警戒状态期间小儿泌尿外科所有手术患者的并发症和再次入院情况。根据解封阶段划分了五个时间段。

结果

对45例患者进行了49台手术(8台在解封阶段实施前)。高优先级病症在第一阶段最为常见,其中输尿管肾盂连接部(UPJ)梗阻最为普遍。记录到4例并发症(8.8%),均非呼吸系统并发症。

结论

欧洲泌尿外科学会(EAU)关于恢复手术活动的建议使得小儿泌尿外科能够正确、安全且逐步地过渡到常规手术活动。Clavien-Dindo分类法在该科室的应用中是有用且有效的。未报告可归因于大流行情况的呼吸系统并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e76e/7498256/1845c62e8351/gr1_lrg.jpg

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