Good Samaritan Medical Center, One Pearl Street, Brockton, MA, USA.
Tufts University School of Medicine, Boston, MA, USA.
Surg Endosc. 2023 Feb;37(2):999-1004. doi: 10.1007/s00464-022-09607-x. Epub 2022 Sep 9.
The COVID-19 pandemic disrupted the healthcare sector and forced hospitals to limit the number of elective procedures with the goal of reducing overcrowding of wards and thus viral transmission. Recent trends for ventral hernia repair have shifted towards retromuscular techniques, which normally require a longer length of stay. Therefore, the aim of this study is to investigate the impact of the COVID-19 pandemic on clinical outcomes of robotic retromuscular ventral hernia repair (rRVHR).
Patients who underwent rRVHR up to 600 days before and after March 10, 2020, were included in this retrospective study and assigned to the pre- or post-COVID group depending on the date of their procedure. Pre-, intra-, and postoperative variables including patients' demographics, hernia characteristics, complications, and hernia recurrence were compared between both groups.
153 (46% female) and 141 (51% female) patients were assigned to the pre- and post-COVID groups respectively. Median age was statistically different between both groups [pre-COVID: 57 (48-68) vs. post-COVID 55 (42-64) years, p = 0.045]. Median hospital length of stay (LOS) was 0 day (0-1) in both groups, and same day discharge were 61% pre-pandemic and 70% post-pandemic (p = 0.09). Mean postoperative follow-up was 39.2 (4.1-93.6) months. In total, 26 pre-COVID patients had postoperative complications, out of which 7 were pulmonary complications, whereas 23 complications were recorded in the post-COVID group, with only 3 pulmonary complications (p = 0.88). Rate of surgical-site events was comparable between both groups, and no recurrences were recorded.
This is the first study to describe the impact of the COVID-19 on rRVHR. Hospital LOS was comparable between both groups. Rates of medical and hernia specific complications were not altered by the pandemic.
COVID-19 大流行扰乱了医疗保健行业，并迫使医院限制择期手术的数量，以减少病房拥挤，从而降低病毒传播的风险。最近，腹外疝修补术的趋势转向了肌后技术，这种技术通常需要更长的住院时间。因此，本研究旨在探讨 COVID-19 对机器人肌后腹外疝修补术（rRVHR）临床结果的影响。
回顾性分析了 2020 年 3 月 10 日前和后 600 天内接受 rRVHR 的患者，根据手术日期将其分为 COVID 前组和 COVID 后组。比较两组患者的术前、术中、术后变量，包括患者的人口统计学特征、疝特征、并发症和疝复发情况。
共纳入 153 例（46%为女性）和 141 例（51%为女性）患者，分别纳入 COVID 前组和 COVID 后组。两组患者的中位年龄存在统计学差异[COVID 前组：57（48-68）岁，COVID 后组：55（42-64）岁，p=0.045]。两组患者的中位住院时间均为 0 天（0-1 天），COVID 前组和 COVID 后组的当日出院率分别为 61%和 70%（p=0.09）。平均术后随访时间为 39.2（4.1-93.6）个月。COVID 前组共有 26 例患者术后发生并发症，其中 7 例为肺部并发症，COVID 后组共有 23 例并发症，其中仅 3 例为肺部并发症（p=0.88）。两组患者的手术部位事件发生率相当，均无复发。
这是第一项描述 COVID-19 对 rRVHR 影响的研究。两组患者的住院时间无差异。疫情并未改变医疗和疝特异性并发症的发生率。
