Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom; Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham B15 2TT, United Kingdom.
Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.
Gynecol Oncol. 2021 Mar;160(3):649-654. doi: 10.1016/j.ygyno.2020.12.013. Epub 2020 Dec 16.
Surgery is the cornerstone of gynecological cancer management, but inpatient treatment may expose both patients and healthcare staff to COVID-19 infections. Plans to mitigate the impact of the COVID-19 pandemic have been implemented widely, but few studies have evaluated the effectiveness of these plans in maintaining safe surgical care delivery.
To evaluate the effects of mitigating plans implemented on the delivery of gynecological cancer surgery during the COVID-19 pandemic.
A comparative cohort study of patients treated in a high-volume tertiary gyneoncological centre in the United Kingdom. Prospectively-recorded consecutive operations performed and early peri-operative outcomes during the same calendar periods (January-August) in 2019 and 2020 were compared.
In total, 585 operations were performed (296 in 2019; 289 in 2020). There was no significant difference in patient demographics. Types of surgery performed were different (p = 0.034), with fewer cytoreductive surgeries for ovarian cancer and laparoscopic procedures (p = 0.002) in 2020. There was no difference in intra-operative complication rates, critical care admission rates or length of stay. One patient had confirmed COVID-19 infection (0.4%). The 30-day post-operative complication rates were significantly higher in 2020 than in 2019 (58 [20.1%] versus 32 [10.8%]; p = 0.002) for both minor and major complications. This increase, primarily from March 2020 onwards, coincided with the first peak of the COVID-19 pandemic in the UK.
Maintaining surgical throughput with meticulous and timely planning is feasible during the COVID-19 pandemic but this was associated with an increase in post-operative complications due to a multitude of reasons.
手术是妇科癌症治疗的基石，但住院治疗可能使患者和医护人员暴露于 COVID-19 感染之下。为了减轻 COVID-19 大流行的影响，已经广泛实施了各种计划，但很少有研究评估这些计划在维持安全的手术护理方面的效果。
评估在 COVID-19 大流行期间实施的缓解计划对妇科癌症手术实施的影响。
这是一项在英国一家高容量的三级妇科肿瘤中心进行的回顾性队列研究。比较了 2019 年和 2020 年同期（1 月至 8 月）连续进行的手术数量和早期围手术期结果。
共进行了 585 例手术（2019 年 296 例，2020 年 289 例）。患者的人口统计学特征无显著差异。所行手术类型不同（p=0.034），2020 年卵巢癌的减瘤手术和腹腔镜手术减少（p=0.002）。术中并发症发生率、重症监护病房入院率或住院时间无差异。1 例患者确诊 COVID-19 感染（0.4%）。2020 年术后 30 天并发症发生率显著高于 2019 年（58 [20.1%] 比 32 [10.8%]；p=0.002），包括轻微和严重并发症。这种增加主要从 2020 年 3 月开始，与英国 COVID-19 大流行的第一波高峰同时发生。
在 COVID-19 大流行期间，通过精心和及时的计划维持手术吞吐量是可行的，但由于多种原因，术后并发症增加。
