Hannan Md Jafrul, Parveen Mosammat Kohinoor, Hoque Md Mozammel, Chowdhury Tanvir Kabir, Hasan Md Samiul, Nandy Alak
Department of Pediatric Surgery, South Point Hospital, Chittagong, Bangladesh.
Department of Pharmacology, Rangamati Medical College, Rangamati, Bangladesh.
JMIR Perioper Med. 2021 Dec 21;4(2):e26613. doi: 10.2196/26613.
Nonoperative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID-19 pandemic on health care, the practice of NOT has generally increased by necessity and may, in a post-COVID-19 world, change surgeons' perceptions of NOT.
The aim of this study was to determine whether the use of NOT has increased in South Asia and whether these levels of practice would be sustained after the pandemic subsides.
A survey was conducted among pediatric surgeons regarding their position, institute, and country; the number of appendicitis cases they managed; and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). The survey also directly posed the question as to whether they would continue with the COVID-19-imposed level of NOT after the effect of the pandemic diminishes.
A total of 134 responses were collected out of 200 (67.0%). A significant increase in the practice of NOT was observed for the entire cohort, although no effect was observed when grouped by country or institute. When grouped by position, senior physicians increased the practice of NOT the most, while junior physicians reported the least change. The data suggest that only professors would be inclined to maintain the COVID-19-level of NOT practice after the pandemic.
Increased practice of NOT during the COVID-19 pandemic was observed in South Asia, particularly by senior surgeons. Only professors appeared inclined to consider maintaining this increased level of practice in the post-COVID-19 world.
与手术治疗相对，小儿阑尾炎的非手术治疗引发了激烈的争论，并且可能受到医生偏好的影响。由于新冠疫情对医疗保健的影响，非手术治疗的应用普遍因必要性而增加，在新冠疫情后的世界，这可能会改变外科医生对非手术治疗的看法。
本研究的目的是确定南亚地区非手术治疗的应用是否增加，以及在疫情消退后这些治疗水平是否会持续。
对小儿外科医生进行了一项调查，内容包括他们的职位、所在机构和国家；他们处理的阑尾炎病例数量；以及他们在2019年和2020年（4月1日至8月31日）相同时间段内的治疗方式。该调查还直接提出了一个问题，即疫情影响减弱后，他们是否会继续维持因新冠疫情而采用的非手术治疗水平。
在200份问卷中，共收集到134份回复（67.0%）。整个队列中观察到非手术治疗的应用显著增加，尽管按国家或机构分组时未观察到影响。按职位分组时， senior physicians增加非手术治疗的应用最多，而 junior physicians报告的变化最小。数据表明，只有教授倾向于在疫情后维持新冠疫情期间的非手术治疗水平。
在南亚地区，新冠疫情期间观察到非手术治疗的应用有所增加，尤其是 senior surgeons。在新冠疫情后的世界，只有教授似乎倾向于考虑维持这种增加的治疗水平。
