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术前新型冠状病毒检测阳性患者延迟手术后的早期术后结局:来自单中心的病例对照研究。

Early postoperative outcomes among patients with delayed surgeries after preoperative positive test for SARS-CoV-2: A case-control study from a single institution.

机构信息

Division of Surgery, AC Camargo Cancer Center, Sao Paulo, Brazil.

Department of Anesthesiology, AC Camargo Cancer Center, Sao Paulo, Brazil.

出版信息

J Surg Oncol. 2021 Mar;123(4):823-833. doi: 10.1002/jso.26377. Epub 2021 Jan 11.

Abstract

BACKGROUND

There are limited data on surgical complications for patients that have delayed surgery after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to analyze the surgical outcomes of patients submitted to surgery after recovery from SARS-CoV-2 infection.

METHODS

Asymptomatic patients that had surgery delayed after preoperative reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 were matched in a 1:2 ratio for age, type of surgery and American Society of Anesthesiologists to patients with negative RT-PCR for SARS-CoV-2.

RESULTS

About 1253 patients underwent surgical procedures and were subjected to screening for SARS-CoV-2. Forty-nine cases with a delayed surgery were included in the coronavirus disease (COVID) recovery (COVID-rec) group and were matched to 98 patients included in the COVID negative (COVID-neg) group. Overall, 22 (15%) patients had 30-days postoperative complications, but there was no statistically difference between groups -16.3% for COVID-rec and 14.3% for COVID-neg, respectively (odds ratio [OR] 1.17:95% confidence interval [CI] 0.45-3.0; p = .74). Moreover, we did not find difference regarding grades more than or equal to 3 complication rates - 8.2% for COVID-rec and 6.1% for COVID-neg (OR 1.36:95%CI 0.36-5.0; p = .64). There were no pulmonary complications or SARS-CoV-2 related infection and no deaths within the 30-days after surgery.

CONCLUSIONS

Our study suggests that patients with delayed elective surgeries due to asymptomatic preoperative positive SARS-CoV-2 test are not at higher risk of postoperative complications.

摘要

背景

关于因严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染而延迟手术的患者的手术并发症数据有限。我们旨在分析从 SARS-CoV-2 感染中康复后接受手术的患者的手术结果。

方法

对于术前 SARS-CoV-2 逆转录聚合酶链反应(RT-PCR)检测呈无症状但手术延迟的患者,按照年龄、手术类型和美国麻醉医师协会(American Society of Anesthesiologists)的比例,与 SARS-CoV-2 RT-PCR 检测呈阴性的患者进行 1:2 配对。

结果

约 1253 名患者接受了手术,并接受了 SARS-CoV-2 的筛查。49 例手术延迟的患者被纳入冠状病毒病(COVID)恢复期(COVID-rec)组,并与 98 例 COVID-neg 组患者匹配。总体而言,有 22 例(15%)患者在术后 30 天内发生并发症,但两组之间无统计学差异-COVID-rec 组为 16.3%,COVID-neg 组为 14.3%(比值比[OR] 1.17:95%置信区间[CI] 0.45-3.0;p=0.74)。此外,我们未发现并发症≥3 级的发生率存在差异-COVID-rec 组为 8.2%,COVID-neg 组为 6.1%(OR 1.36:95%CI 0.36-5.0;p=0.64)。术后 30 天内无肺部并发症或 SARS-CoV-2 相关感染,也无死亡病例。

结论

我们的研究表明,因术前 SARS-CoV-2 检测呈阳性但无症状而延迟择期手术的患者,术后并发症风险并未增加。

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