Department of Urology, Beaumont Hospital, Dublin, Ireland.
Department of Surgery, The Royal College of Surgeons in Ireland, Dublin, Ireland.
Ir J Med Sci. 2021 Aug;190(3):919-923. doi: 10.1007/s11845-020-02438-6. Epub 2020 Nov 17.
The risk of acquiring perioperative SARS-CoV-2 infection is concerning for surgeons and patients.
In this study, we investigate the incidence of postponed, medically necessary, time-sensitive urological procedures due to a patient's unwillingness to proceed to a recommended surgical intervention during the first phase of the SARS-CoV-2 pandemic.
We prospectively monitored all patients undergoing elective urological surgery during the initial phase of the SARS-CoV-2 pandemic. The primary outcome measurement was incidence of postponed, medically necessary, urological procedures due to the patient's decision not to proceed to a recommended urological intervention (16th of March-5th of June 2020). The secondary outcome measurements were the type of delayed procedure and duration of postponement.
During the initial 12-week period of the SARS-CoV-2 pandemic, 155 elective urgent urological procedures were scheduled after pre-operative SARS-CoV-2 screening. In total, 140 procedures were performed and 15 (10%) patients intentionally delayed their urological procedure due to the perceived risk of acquiring nosocomial perioperative SARS-CoV-2 infection. The duration for procedural delays is currently 42 ± 23 (range: 15-80) days. The most frequently postponed procedures among patients unwilling to proceed to surgery are urgent endourological procedures due to symptomatic urolithiasis (n = 7/15).
The incidence for patients postponing urological procedures due to the risk of acquiring nosocomial SARS-CoV-2 is 10%. Endourological procedures for urolithiasis are the most frequently postponed procedures by patients. This study demonstrates that a subset of patients will decline urgent urological surgery during the SARS-CoV-2 pandemic.
外科医生和患者都非常关注围手术期感染 SARS-CoV-2 的风险。
本研究旨在调查由于患者不愿意接受推荐的手术干预，而导致推迟的、有医学必要的、时间敏感的泌尿外科手术的发生率，这些手术是在 SARS-CoV-2 大流行的第一阶段。
我们前瞻性地监测了 SARS-CoV-2 大流行初始阶段接受择期泌尿外科手术的所有患者。主要结局测量指标是由于患者决定不接受推荐的泌尿外科干预而推迟的、有医学必要的、泌尿外科手术的发生率（2020 年 3 月 16 日至 6 月 5 日）。次要结局测量指标是延迟手术的类型和延迟时间。
在 SARS-CoV-2 大流行的最初 12 周内，在术前 SARS-CoV-2 筛查后安排了 155 例紧急择期泌尿外科手术。总共进行了 140 例手术，有 15 名（10%）患者由于担心获得医院获得性围手术期 SARS-CoV-2 感染的风险而故意推迟其泌尿外科手术。手术延迟的持续时间目前为 42 ± 23（范围：15-80）天。不愿意进行手术的患者中最常推迟的手术是由于症状性尿路结石而进行的紧急腔内泌尿外科手术（n = 7/15）。
由于担心获得医院获得性 SARS-CoV-2 感染的风险而推迟泌尿外科手术的患者发生率为 10%。结石病的腔内泌尿外科手术是患者最常推迟的手术。本研究表明，在 SARS-CoV-2 大流行期间，有一部分患者会拒绝接受紧急的泌尿外科手术。
