Department of Gastrointestinal Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Region Metropolitana, Chile.
Surg Endosc. 2021 Nov;35(11):6300-6306. doi: 10.1007/s00464-020-08130-1. Epub 2020 Nov 2.
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.
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.
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.
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.
本前瞻性研究旨在比较在 COVID-19 大流行期间,胃肠道手术后使用远程医疗诊所与面对面随访进行术后护理的效果。
纳入自 COVID-19 爆发以来接受腹部手术的所有患者。出院时,患者可选择通过远程医疗或亲自就诊进行术后随访预约。分析人口统计学、围手术期和随访变量。
在 219 名接受腹部手术的患者中,有 106 名(48%)通过远程医疗进行了术后随访。两组在年龄、性别、ASA 评分和 COVID-19 阳性率方面无差异。与面对面随访相比,选择远程医疗的患者更有可能接受腹腔镜手术(71%比 51%,P=0.037)和急诊手术(55%比 41%,P=0.038)。远程医疗组和面对面组的发病率分别为 5.7%和 8%(P=0.50)。仅有 2.8%的患者需要在远程医疗咨询后进行面对面就诊,1.9%的患者就诊于急诊部。
在当前大流行期间,远程医疗随访可安全有效地应用于选定的外科患者。接受腹腔镜和急诊手术的患者比面对面随访更倾向于选择远程医疗。