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COVID-19 大流行期间造口关闭率:一项意大利多中心观察性研究。

Ostomy closure rate during COVID-19 pandemic: an Italian multicentre observational study.

机构信息

UOC of General and Minimally Invasive Surgery, Hospital "San Paolo", Largo Donatori del Sangue 1, Civitavecchia, 00053, Rome, Italy.

Ph.D. Program in Applied Medical-Surgical Sciences, Department of General Surgery, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.

出版信息

Updates Surg. 2022 Jun;74(3):1017-1025. doi: 10.1007/s13304-022-01274-w. Epub 2022 Mar 24.

Abstract

During the corona virus disease 2019 (COVID-19) pandemic, most of the surgical procedures were performed for emergencies or oncologic reasons to the detriment of the remaining elective procedures for benign conditions. Ileostomy or colostomy creation are sequelae of oncologic or emergency colorectal surgery, but their closure does not fall within the definition of oncologic or emergency surgery. The aim of this retrospective multicentre observational study is to report the impact of COVID-19 pandemic on the ostomy closure rate in Italy. Data regarding ileostomy and colostomy creation and closure from 24 Italian centres, during the study period (March 2020-February 2021) and during the control period (March 2019-February 2020) were collected. Three hospitals (12.5%) were COVID free. The number of colostomies and ileostomies created and closed in the same period was lower ( -18.8% and -30%, respectively) in the study period in comparison to the control period (p = 0.1915 and p = 0.0001, respectively), such as the ostomies closed in the analysed periods but created before (colostomy -36.2% and ileostomy -7.4%, p = 0.2211 and p = 0.1319, respectively). Overall, a 19.5% reduction in ostomies closed occurred in the study period. Based on the present study, a reduction in ostomy closure rate occurred in Italy between March 2020 and February 2021. During the pandemic, the need to change the clinical practice probably prolonged deterioration of quality of life in patients with ostomies, increasing number of stomas that will never be closed, and related management costs, even if these issues have not been investigated in this study.

摘要

在 2019 年冠状病毒病(COVID-19)大流行期间,大多数手术是为紧急情况或肿瘤原因而进行的,而良性疾病的剩余择期手术则受到影响。回肠造口术或结肠造口术是肿瘤或紧急结直肠手术的后遗症,但它们的关闭不属于肿瘤或紧急手术的定义。本回顾性多中心观察性研究的目的是报告 COVID-19 大流行对意大利造口关闭率的影响。在研究期间(2020 年 3 月至 2021 年 2 月)和对照期间(2019 年 3 月至 2020 年 2 月),从意大利 24 个中心收集了回肠造口术和结肠造口术的创建和关闭的数据。有 3 家医院(12.5%)无 COVID-19。与对照期相比,研究期内创建和关闭的结肠造口术和回肠造口术数量均减少(分别减少 18.8%和 30%)(p=0.1915 和 p=0.0001),同样,在分析期间创建但在此之前关闭的造口术也有所减少(结肠造口术减少 36.2%,回肠造口术减少 7.4%)(p=0.2211 和 p=0.1319)。总的来说,在研究期间,造口术的关闭数量减少了 19.5%。基于本研究,2020 年 3 月至 2021 年 2 月期间,意大利的造口关闭率有所下降。在大流行期间,改变临床实践的必要性可能使造口患者的生活质量恶化进一步恶化,增加永远不会关闭的造口数量,并增加相关管理成本,尽管这些问题在本研究中尚未调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5a6/8942758/ce0f467eeb7f/13304_2022_1274_Fig1_HTML.jpg

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