Lahat Adi, Benjamin Avidan
Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Clin Endosc. 2021 Jan;54(1):48-54. doi: 10.5946/ce.2020.132. Epub 2020 Nov 6.
BACKGROUND/AIMS: The coronavirus disease-19 (COVID-19) pandemic forced endoscopy units to enact major changes on daily practice and policy. The Chaim Sheba Medical Center is a tertiary referral center located in the center of Israel, and serves cities with high infection rates. Our aim was to review the policies enacted during this outbreak and study their influence on the performance of endoscopic procedures.
Following the revision of work protocols, personnel were divided into two permanent and physically separate working groups and screening procedures were rescheduled. Relevant data including the number of endoscopic examinations, type of procedure performed, and patient referrals and indications were taken from a computerized database and evaluated. The study included data for January-March 2018-2020, and a comparison among the data from each year was performed.
As of March 2020, the total number of endoscopic examinations performed reduced by 44% (p<0.0001) as compared to previous years, gastroscopy examinations reduced by 39% (p=0.02), and lower endoscopy procedures reduced by 57% (p<0.0001). Meanwhile, the number of advanced endoscopic procedures performed remained consistent with previous years. The indications for performance of gastroscopy and lower endoscopy were different in March 2020, while these remained unchanged for advanced endoscopic procedures.
The current policy appears to serve both our initial goals: protecting personnel and patients' safety and minimizing potential damage from delayed endoscopic procedures. A longer term follow-up study is needed in order to fully analyze our results.
背景/目的：2019冠状病毒病（COVID-19）大流行迫使内镜科室在日常实践和政策上做出重大改变。海姆·谢巴医疗中心是位于以色列中部的三级转诊中心，服务于感染率较高的城市。我们的目的是回顾疫情期间制定的政策，并研究其对内镜检查操作的影响。
修订工作流程后，工作人员被分为两个固定且物理隔离的工作组，并重新安排了筛查程序。从计算机数据库中获取包括内镜检查数量、所执行的操作类型以及患者转诊和指征等相关数据并进行评估。该研究纳入了2018 - 2020年1月至3月的数据，并对每年的数据进行了比较。
截至2020年3月，与前几年相比，内镜检查的总数减少了44%（p<0.0001），胃镜检查减少了39%（p = 0.02），乙状结肠镜检查减少了57%（p<0.0001）。同时，所执行的高级内镜检查数量与前几年保持一致。2020年3月胃镜和乙状结肠镜检查的指征有所不同，而高级内镜检查的指征保持不变。
当前政策似乎实现了我们最初的两个目标：保护工作人员和患者的安全，并将内镜检查延迟造成的潜在损害降至最低。需要进行更长期的随访研究以全面分析我们的结果。
