大流行对神经外科肿瘤学的影响——在危机早期保持功能。

Impact of a pandemic on surgical neuro-oncology-maintaining functionality in the early phase of crisis.

机构信息

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 201206, China.

Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai, 201206, China.

出版信息

BMC Surg. 2021 Jan 18;21(1):40. doi: 10.1186/s12893-021-01055-z.

DOI:10.1186/s12893-021-01055-z

PMID:33461509

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7812331/

Abstract

BACKGROUND

The Coronavirus disease 2019 (COVID-19) pandemic has extraordinarily impacted global healthcare. Neuro-oncological surgery units have peculiar features that make them highly relevant in the strategic reaction to the pandemic. In this Chinese Society of Neuro-Oncology (CSNO) initiated survey, we appraise the changes implemented in neuro-oncological surgery hospitals across different Asian countries and provide expert recommendations for responses at different stages of the pandemic.

METHODS

We performed a 42-question survey of the early experience of neuro-oncological surgery practice in hospitals across different Asian countries on April 1, 2020, with responses closed on April 18, 2020.

RESULTS

144 hospitals completed the questionnaire. Most were in WHO post-peak phase of the pandemic and reported a median reduction in neuro-oncological surgery volume of 25-50%. Most (67.4%) resumed elective surgery in only COVID-19 negative patients;11.1% performed only emergency cases irrespective of COVID-19 status;2.1% suspended all surgical activity. Ninety-one (63.2%) relocated personnel from neurosurgery to other departments. Fifty-two (36.1%) hospitals suspended post-operative adjuvant therapy and 94 (65.2%) instituted different measures to administer post-operative adjuvant therapy. Majority (59.0%) of the hospitals suspended research activity. Most (70%) respondents anticipate that current neurosurgery restrictions will continue to remain for > 1 month.

CONCLUSIONS

Majority of the respondents to our survey reported reduced neuro-oncological surgery activity, policy modification, personnel reallocation, and curtailment of educational/research activities in response to the COVID-19 pandemic. The persistent widespread interruption of surgical neuro-oncology in even post-peak phases of the pandemic raises serious concerns about the long-term impact of the pandemic on neuro-oncological patients and highlights the essence of timely measures for pandemic preparedness, patient triage, and workforce protection.

摘要

背景

2019 年冠状病毒病（COVID-19）大流行对全球医疗保健产生了巨大影响。神经肿瘤外科学科具有独特的特点，使其在应对大流行的战略反应中具有重要意义。在中国神经肿瘤学会（CSNO）发起的这项调查中，我们评估了不同亚洲国家神经肿瘤外科学科医院实施的变化，并为大流行不同阶段的应对措施提供了专家建议。

方法

我们于 2020 年 4 月 1 日对不同亚洲国家医院的神经肿瘤外科学科早期实践经验进行了一项包含 42 个问题的调查，于 2020 年 4 月 18 日关闭了答复。

结果

共有 144 家医院完成了问卷。大多数医院处于世界卫生组织大流行高峰期过后阶段，报告神经肿瘤外科学科手术量中位数减少了 25%-50%。大多数（67.4%）仅对 COVID-19 阴性患者恢复择期手术；11.1%无论 COVID-19 状态如何，仅进行紧急情况手术；2.1%暂停了所有手术活动。91（63.2%）名工作人员从神经外科调配到其他科室。52（36.1%）家医院暂停了术后辅助治疗，94（65.2%）家医院采取了不同措施来管理术后辅助治疗。大多数（59.0%）医院暂停了研究活动。大多数（70%）的调查对象预计，目前的神经外科限制将持续超过 1 个月。

结论

我们调查的大多数受访者报告称，为应对 COVID-19 大流行，神经肿瘤外科学科的活动减少、政策修改、人员重新调配以及教育/研究活动减少。即使在大流行高峰期过后阶段，神经肿瘤外科学科手术的持续广泛中断引起了人们对大流行对神经肿瘤患者的长期影响的严重关切，并强调了及时采取大流行防范、患者分诊和劳动力保护措施的重要性。