Department of Urology, St Helens and Knowsley NHS Trust, Whiston Hospital, Prescot, Merseyside, UK.
Urologia. 2023 May;90(2):407-414. doi: 10.1177/03915603221136321. Epub 2022 Nov 8.
COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency surgical care. Specific to Merseyside, Tier 4, Tier 2 and Tier 5 restrictions were introduced in late 2020 and early 2021. The purpose of this study was to examine the nature and workload of emergency urological procedures during three different national lockdown Tiers in the North West of England.
A 3-month prospective study examining all emergency urological activity was conducted from November 2020 when Tier 4 restrictions were introduced and included Tier 2 restrictions in December and then concluded at the end of January 2021 when Tier 5 restrictions were in place. Data was obtained by identifying patients using the electronic theatre listing system.
A total of 71 emergency cases were performed (24 in November (Tier 4), 28 in December (Tier 2), 19 in January 2021 (Tier 5)) with 15 different types of procedures performed. The most frequently performed procedure was stent insertion (36), followed by scrotal exploration (10). The least commonly performed procedure was suprapubic catheter insertion under general anaesthesia (1). One patient required transfer to a different hospital. In total 6 calls were made by general surgery and 3 by gynaecology for urgent urological assistance in theatre. Three urology patients returned to the theatre as emergencies following elective procedures.
Unlike the Spring lockdown, acute urological presentations requiring operative intervention still presented daily. Of the 71 cases performed, most occurred in Tier 2. Stent insertion was the most commonly performed procedure, with the majority of the cases performed by registrars.
新冠疫情导致英国各地实施分级区域限制措施，继而对计划内和紧急手术护理产生影响。具体到默西塞德郡，2020 年末和 2021 年初先后实施了四级、二级和五级限制措施。本研究旨在探讨英格兰西北部在三个不同国家封锁级别下急诊泌尿外科手术的性质和工作量。
这是一项为期 3 个月的前瞻性研究，对所有急诊泌尿外科活动进行检查，研究从 2020 年 11 月四级限制措施实施时开始，包括 12 月的二级限制措施，然后在 2021 年 1 月底五级限制措施实施时结束。数据通过电子手术室清单系统识别患者获得。
共进行了 71 例急诊手术（11 月四级限制时 24 例，12 月二级限制时 28 例，1 月 5 级限制时 19 例），共进行了 15 种不同类型的手术。最常进行的手术是支架置入（36 例），其次是阴囊探查（10 例）。最不常进行的手术是全身麻醉下耻骨上导尿（1 例）。一名患者需要转院。普外科共呼叫 6 次，妇产科呼叫 3 次，要求紧急在手术室提供泌尿外科援助。3 例泌尿外科患者在择期手术后返回手术室紧急处理。
与春季封锁不同，仍有需要手术干预的急性泌尿外科就诊。在进行的 71 例手术中，大多数发生在二级限制时。支架置入是最常进行的手术，大多数由住院医师进行。
