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[COVID-19疫情对泌尿外科手术等候名单的影响及后COVID-19时代等候名单的优先排序策略]

[Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the Post-COVID-19 era].

作者信息

García-Rojo E, Manfredi C, Santos-Pérez-de-la-Blanca R, Tejido-Sánchez Á, García-Gómez B, Aliaga-Benítez M, Romero-Otero J, Rodriguez-Antolín A

机构信息

Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España.

Departamento de Cirugía de la Mujer, el Niño y Cirugía General y Especializada, Universidad de Campania «Luigi Vanvitelli», Nápoles, Italia.

出版信息

Actas Urol Esp (Engl Ed). 2021 Apr;45(3):207-214. doi: 10.1016/j.acuro.2020.11.001. Epub 2020 Nov 7.

Abstract

INTRODUCTION

The suspension of most elective surgeries during COVID-19 pandemic caused the lengthening of urology surgical waiting lists. The objective of this study is to evaluate the impact of COVID-19 pandemic on urology surgical waiting list in a high-volume hospital.

METHODS

An observational descriptive study was designed. All patients included in the urology surgical waiting list of our high-volume center on May 1 2020 (46 days after the suspension of elective surgery) were analyzed. Baseline variables, priority on the waiting list, main urological disease, type of scheduled surgery, and waiting time were recorded. Other variables recorded were the presence of a urinary catheter, number of accesses to the emergency department, evidence of COVID-19 infection, number of deaths and their cause. The waiting time for each disease was compared with the time to surgery in 2019.

RESULTS

A total of 350 patients were included. The mean (SD) time on the waiting list was 97.33 (55.47) days. Priority 1 patients, who normally should undergo surgery within 30 days, were on the waiting list for a mean (SD) time of 60.51 (20.14) days. They were mainly patients with ureteral lithiasis (25.6%), high-risk or muscle-invasive bladder cancer (20.9%) and high-risk prostate cancer (13.9%). The mean waiting time had already significantly exceeded the mean time to surgery in 2019 for radical cystectomy (p = 0.04) and URS (p = 0.003).

CONCLUSIONS

The suspension of most elective surgeries due to COVID-19 had a significant impact on urology surgical waiting list of our high-volume center, especially in priority 1 group.

摘要

引言

在新冠疫情期间,大多数择期手术的暂停导致泌尿外科手术等待名单延长。本研究的目的是评估新冠疫情对一家大型医院泌尿外科手术等待名单的影响。

方法

设计了一项观察性描述性研究。对2020年5月1日(择期手术暂停46天后)我们大型中心泌尿外科手术等待名单上的所有患者进行分析。记录基线变量、在等待名单上的优先级、主要泌尿系统疾病、预定手术类型和等待时间。记录的其他变量包括是否留置导尿管、前往急诊科的次数、新冠病毒感染证据、死亡人数及其原因。将每种疾病的等待时间与2019年的手术时间进行比较。

结果

共纳入350例患者。等待名单上的平均(标准差)时间为97.33(55.47)天。优先级1的患者通常应在30天内接受手术,其在等待名单上的平均(标准差)时间为60.51(20.14)天。他们主要是输尿管结石患者(25.6%)、高危或肌层浸润性膀胱癌患者(20.9%)和高危前列腺癌患者(13.9%)。对于根治性膀胱切除术(p = 0.04)和输尿管镜检查(p = 0.003),平均等待时间已显著超过2019年的平均手术时间。

结论

由于新冠疫情导致大多数择期手术暂停,对我们大型中心的泌尿外科手术等待名单产生了重大影响,尤其是在优先级1组。

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