Saha Sushmita, Roy Kallol Kumar, Zangmo Rinchen, Das Anamika, Bharti Juhi, Rai Rakhi, Kumari Archana, Suresh Gayatri, Noor Nilofar, Vanamail Perumal
Department of Obstetrics and Gynaecology, All India Institute of Medical Science, New Delhi, India.
Obstet Gynecol Sci. 2021 Jul;64(4):383-389. doi: 10.5468/ogs.21029. Epub 2021 Apr 1.
The novel coronavirus pandemic led to the suspension of elective surgeries and the diversion of resources and manpower towards pandemic control. However, gynecological emergencies and malignancies must be addressed despite the restricted resources and the need for protective measures against COVID-19. This study aimed to determine the types of gynecological surgeries performed, difficulties encountered, and their outcomes in the setting of the pandemic.
We performed a prospective cohort study over 6 months at a single tertiary center, including 60 women with gynecological complaints, categorized as emergencies and semi-emergencies, who underwent further surgery. Their surgical outcomes were measured through various parameters.
We found that 68.3% were emergency cases, while the rest were classified as semi-emergencies. Fibroid and adenomyosis with failed medical management (48.3%), followed by cervical intraepithelial neoplasia (10%), and malignancies (10%) accounted for the semi-emergency cases, while ruptured ectopic pregnancies (13.3%) and torsion and ovarian cysts (18.4%) comprised the emergency cases. The decision to incision time between emergency and semi-emergency cases varied widely due to the safety prerequisites during the pandemic, ranging from 1 hour in emergency cases to 48 hours in semi-emergency cases. In addition, we studied the ease of preoperative preparation, patient satisfaction, and the average number of personnel available to run the operation theaters at these times. No serious perioperative adverse events were observed in the present study.
In conclusion, gynecological surgeries could continue to be safely performed with all precautions in place against COVID-19 infection and related morbidities.
新型冠状病毒大流行导致择期手术暂停，资源和人力转向疫情防控。然而，尽管资源有限且需要采取针对新冠病毒病的防护措施，但仍必须处理妇科急症和恶性肿瘤。本研究旨在确定在大流行背景下进行的妇科手术类型、遇到的困难及其结果。
我们在一家单一的三级中心进行了为期6个月的前瞻性队列研究，纳入60例有妇科主诉的女性，分为急症和半急症，她们接受了进一步手术。通过各种参数衡量其手术结果。
我们发现68.3%为急症病例，其余为半急症病例。药物治疗失败的子宫肌瘤和子宫腺肌病（48.3%），其次是宫颈上皮内瘤变（10%）和恶性肿瘤（10%）占半急症病例，而破裂的异位妊娠（13.3%）和卵巢囊肿扭转（18.4%）构成急症病例。由于大流行期间的安全前提，急症和半急症病例之间的切开时间决定差异很大，急症病例从1小时到半急症病例的48小时不等。此外，我们研究了术前准备的难易程度、患者满意度以及此时可用于手术室运作的平均人员数量。本研究未观察到严重的围手术期不良事件。
总之，在采取所有预防措施以防止新冠病毒感染及相关发病的情况下，妇科手术可以继续安全进行。
