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SARS-CoV-2 大流行期间的小儿外科学术活动:一家三级医院的经验。

Pediatric surgical activity during the SARS-CoV-2 pandemic: experience at a tertiary hospital.

机构信息

Pediatric Surgery Department. Gregorio Marañón Pediatric-Maternal Hospital. Madrid (Spain).

出版信息

Cir Pediatr. 2021 Jan 1;34(1):28-33.

Abstract

OBJECTIVES

The primary objective was to describe the characteristics and demographics of the surgical procedures carried out at a tertiary hospital during the SARS-CoV-2 pandemic. The secondary objective was to study the impact of the pandemic on the acute appendicitis cases treated at our healthcare facility and to compare them with a pre- SARS-CoV-2 period.

MATERIAL AND METHODS

A retrospective study of all patients undergoing surgery at the pediatric surgery department in the pandemic period, from the beginning of the state of emergency in Spain until the first restrictions were removed, was conducted.

RESULTS

A total of 61 patients underwent surgery in 58 days vs. 406 patients in the same 2019 period (p < 0.00001). 59.01% of surgeries were urgent. 5.1% of patients had a positive SARS-CoV-2 diagnostic test. 30 different procedures were carried out, with appendectomy being the most frequent one (n = 13, 19.6% of patients). 61.5% of appendicitis cases were complicated vs. 42.4% in the non-COVID period (p = 0.17). Surgical approach was open in 46.1% of patients vs. 6.1% in the non-COVID period (p = 0.004). No statistically significant differences were found in terms of complication rate or hospital stay.

CONCLUSIONS

During the SARS-CoV-2 pandemic, a significant decrease in the number of daily procedures was noted, with more than half being urgent. Appendicular pathologies were in a more advanced stage than usual, with a clear trend towards open surgery vs. laparoscopy.

摘要

目的

主要目的是描述在 SARS-CoV-2 大流行期间,一家三级医院进行的手术的特点和人口统计学特征。次要目的是研究大流行对我们医疗机构治疗的急性阑尾炎病例的影响,并将其与 SARS-CoV-2 之前的时期进行比较。

材料和方法

对在西班牙紧急状态开始至首次解除限制期间在小儿外科部门接受手术的所有患者进行了回顾性研究。

结果

共有 61 名患者在 58 天内接受了手术,而 2019 年同期有 406 名患者(p < 0.00001)。59.01%的手术为紧急手术。5.1%的患者 SARS-CoV-2 诊断检测呈阳性。共进行了 30 种不同的手术,其中阑尾切除术最为常见(n = 13,占患者的 19.6%)。61.5%的阑尾炎病例为复杂型,而非 COVID 期为 42.4%(p = 0.17)。开放性手术在 46.1%的患者中进行,而非 COVID 期为 6.1%(p = 0.004)。在并发症发生率或住院时间方面未发现统计学差异。

结论

在 SARS-CoV-2 大流行期间,每日手术数量显著减少,其中超过一半为紧急手术。阑尾疾病处于比平时更晚期的阶段,明显倾向于开放手术而非腹腔镜手术。

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