Department of Specialist Neonatal and Paediatric Surgery Great, Ormond Street Hospital NHS Trust, London, UK.
NIHR Biomedical Research Center, Great Ormond Street Hospital, London, UK.
Pediatr Surg Int. 2022 May;38(5):769-775. doi: 10.1007/s00383-022-05107-0. Epub 2022 Mar 25.
The safety of minimally invasive surgery (MIS) was questioned in the COVID-19 pandemic due to concern regarding disease spread. We continued MIS during the pandemic with appropriate protective measures. This study aims to assess the safety of MIS compared to Open Surgery (OS) in this setting.
Operations performed during 2020 lockdown were compared with operations from the same time-period in 2019 and 2021. Outcomes reviewed included all complications, respiratory complications, length of stay (LOS) and operating surgeon COVID-19 infections (OSI).
In 2020, MIS comprised 52% of procedures. 29% of MIS 2020 had complications (2019: 24%, 2021: 15%; p = 0.08) vs 47% in OS 2020 (p = 0.04 vs MIS). 8.5% of MIS 2020 had respiratory complications (2019: 7.7%, 2021: 6.9%; p = 0.9) vs 10.5% in OS 2020 (p = 0.8 vs MIS). Median LOS[IQR] for MIS 2020 was 2.5[6] days vs 5[23] days in OS 2020 (p = 0.06). In 2020, 2 patients (1.2%) were COVID-19 positive (MIS: 1, OS: 1) and there were no OSI.
Despite extensive use of MIS during the pandemic, there was no associated increase in respiratory or other complications, and no OSI. Our study suggests that, with appropriate protective measures, MIS can be performed safely despite high levels of COVID-19 in the population.
由于担心疾病传播，微创外科 (MIS) 在 COVID-19 大流行期间的安全性受到质疑。我们在大流行期间采取了适当的保护措施继续进行 MIS。本研究旨在评估在此背景下与开放手术 (OS) 相比 MIS 的安全性。
比较 2020 年封锁期间进行的手术与 2019 年和 2021 年同期的手术。回顾的结果包括所有并发症、呼吸系统并发症、住院时间 (LOS) 和手术医生 COVID-19 感染 (OSI)。
2020 年，MIS 占手术的 52%。2020 年 MIS 中有 29%（2019 年：24%，2021 年：15%；p=0.08）出现并发症，而 2020 年 OS 中则有 47%（p=0.04 与 MIS 相比）。2020 年 MIS 中有 8.5%（2019 年：7.7%，2021 年：6.9%；p=0.9）出现呼吸系统并发症，而 2020 年 OS 中则有 10.5%（p=0.8 与 MIS 相比）。2020 年 MIS 的中位 LOS[IQR]为 2.5[6]天，而 OS 为 5[23]天（p=0.06）。2020 年有 2 名患者（1.2%）COVID-19 阳性（MIS：1 例，OS：1 例），无 OSI。
尽管在大流行期间广泛使用 MIS，但呼吸系统或其他并发症没有增加，也没有 OSI。我们的研究表明，在人群中 COVID-19 水平较高的情况下，采取适当的保护措施，MIS 可以安全进行。
