González-Díaz A, Abad-López P, Peña-Vallejo E, Caro-González M P, Calzas-Montalvo C, Gil-Moradillo J, Miranda-Utrera N, Díez-Sebastián J, Varela-Rodríguez C, Rodríguez-Antolín A, Tejido-Sánchez A
Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria 12 de Octubre i+12 (imas12), Madrid, España.
Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria 12 de Octubre i+12 (imas12), Madrid, España.
Actas Urol Esp (Engl Ed). 2020 Dec;44(10):665-673. doi: 10.1016/j.acuro.2020.09.007. Epub 2020 Sep 29.
The SARS-CoV-2 pandemic has changed the urological practice around the world. Our objective is to describe the outcomes presented by patients undergoing surgery in the urology department of a tertiary hospital, across the pandemic phases.
Observational, cohort study including all patients undergoing surgery from March 1 to May 14. According to the hospital organization, we identified three periods: there were no changes during the first two weeks (1. period), the following seven weeks, when only urgent interventions were carried out after performance of nasopharyngeal swab test (2. period), and finally, elective surgery was resumed on May 4, after the implementation of a multidisciplinary screening protocol (3. period). Demographic, baseline, surgical and perioperative variables, as well as postoperative outcomes, were obtained in a retrospective (periods 1 and 2) and prospective (period 3) manner. Telephone follow-up was initiated at least 3 weeks after hospital discharge.
103 urological surgeries were performed, and 11 patients were diagnosed with COVID-19, 8 of them within the 1.
The diagnosis was already known in 1 patient, while the other 10 developed the disease in an average of 25 days after the intervention and 16,6 days after discharge. Of seven transplant patients, four got the infection. Three deaths were recorded due to the disease: a 69-year-old woman transplanted and two men over 80 with comorbidities and high anesthetic risk who underwent drainage of retroperitoneal abscess and retrograde intrarenal surgery, respectively.
SARS-CoV-2 infection mainly affected renal transplant recipients or elderly patients with high anesthetic risk, during the first 2 weeks of the pandemic. After implementing preoperative PCR tests and a comprehensive screening protocol, cases were substantially reduced, and safe surgical procedures were achieved.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行改变了全球泌尿外科的诊疗实践。我们的目标是描述一家三级医院泌尿外科患者在整个大流行阶段接受手术的结果。
观察性队列研究，纳入3月1日至5月14日期间所有接受手术的患者。根据医院安排，我们确定了三个时期：前两周无变化（第1期）；接下来的七周，仅在进行鼻咽拭子检测后进行紧急干预（第2期）；最后，在实施多学科筛查方案后，5月4日恢复择期手术（第3期）。通过回顾性（第1期和第2期）和前瞻性（第3期）方式获取人口统计学、基线、手术和围手术期变量以及术后结果。出院后至少3周开始电话随访。
共进行了103例泌尿外科手术，11例患者被诊断为新型冠状病毒肺炎，其中8例在第1期被诊断。1例患者诊断时已知患有该病，其他10例在干预后平均25天、出院后16.6天患病。7例移植患者中有4例感染。记录到3例因该病死亡：1例69岁接受移植的女性，2例80岁以上患有合并症且麻醉风险高的男性，分别接受了腹膜后脓肿引流术和逆行肾内手术。
在大流行的前两周，SARS-CoV-2感染主要影响肾移植受者或麻醉风险高的老年患者。实施术前聚合酶链反应检测和综合筛查方案后，病例大幅减少，并实现了安全的手术操作。
