Committee for Novel Coronavirus Disease 2019 Outbreak of Japanese Surgical Society, Tokyo, Japan.
Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Surg Today. 2022 Jan;52(1):22-35. doi: 10.1007/s00595-021-02406-2. Epub 2021 Nov 16.
BACKGROUND AND PURPOSE: The spread of COVID-19 has restricted the delivery of standard medical care to surgical patients dramatically. Surgical triage is performed by considering the type of disease, its severity, the urgency for surgery, and the condition of the patient, in addition to the scale of infectious outbreaks in the region. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the number of surgical procedures performed and whether the effects were more prominent during certain periods of widespread infection and in the affected regions. METHODS: We selected 20 of the most common procedures from each surgical field and compared the weekly numbers of each operation performed in 2020 with the respective numbers in 2018 and 2019, as recorded in the National Clinical Database (NCD). The surgical status during the COVID-19 pandemic as well as the relationship between surgical volume and the degree of regional infection were analyzed extensively. RESULTS: The rate of decline in surgery was at most 10-15%. Although the numbers of most oncological and cardiovascular procedures decreased in 2020, there was no significant change in the numbers of pancreaticoduodenectomy and aortic replacement procedures performed in the same period. CONCLUSION: The numbers of most surgical procedures decreased in 2020 as a result of the COVID-19 pandemic; however, the precise impact of surgical triage on decrease in detection of disease warrants further investigation.
背景与目的:COVID-19 的传播极大地限制了外科患者的标准医疗服务的提供。外科分诊除了考虑疾病的类型、严重程度、手术的紧迫性和患者的状况外,还需要考虑到该地区传染病的规模。本研究旨在评估 COVID-19 大流行对手术数量的影响,以及这些影响在广泛感染期和受影响地区是否更为显著。
方法:我们从每个外科领域中选择了 20 种最常见的手术,并将 2020 年每周进行的每种手术数量与 2018 年和 2019 年全国临床数据库(NCD)记录的相应数量进行了比较。我们广泛分析了 COVID-19 大流行期间的外科状况以及手术量与区域感染程度之间的关系。
结果:手术下降的幅度最多为 10-15%。虽然 2020 年大多数肿瘤和心血管手术的数量有所减少,但同期胰十二指肠切除术和主动脉置换术的数量没有明显变化。
结论:COVID-19 大流行导致 2020 年大多数外科手术数量减少;然而,外科分诊对疾病检出减少的确切影响需要进一步研究。
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