Shiroshita Hidefumi, Endo Hideki, Inomata Masafumi, Akagi Tomonori, Yamamoto Hiroyuki, Yamaguchi Shigeki, Eguchi Susumu, Wada Norihito, Kurokawa Yukinori, Seki Yosuke, Sakai Yoshiharu, Miyata Hiroaki, Kakeji Yoshihiro, Kitagawa Yuko, Taketomi Akinobu, Mori Masaki
Academic Committee of Japan Society for Endoscopic Surgery Tokyo Japan.
Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.
Ann Gastroenterol Surg. 2023 Feb 15;7(4):572-582. doi: 10.1002/ags3.12660. eCollection 2023 Jul.
This study aimed to evaluate the impact of the coronavirus disease (COVID-19) pandemic on elective endoscopic surgeries in Japan using the National Clinical Database.
We retrospectively analyzed the clinicopathological factors and surgical outcomes of laparoscopic cholecystectomy (LC), laparoscopic distal gastrectomy (LDG), and laparoscopic low anterior resection (LLAR) and compared the monthly numbers of each procedure performed in 2020 with those in 2018 and 2019. The degree of infection in prefectures was classified into low and high groups.
In 2020, the number of LCs (except for acute cholecystitis) was 76 079 (93.0% of that in 2019), the number of LDGs was 14 271 (85.9% of that in 2019), and the number of LLARs was 19 570 (88.1% of that in 2019). Although the number of robot-assisted LDG and LLAR cases increased in 2020, the growth rate was mild compared with that in 2019. There was little difference in the number of cases in the degree of infection in the prefectures. The numbers of LC, LDG, and LLAR cases decreased from May to June and recovered gradually. In late 2020, the proportion of T4 and N2 cases of gastric cancer and the number of T4 cases of rectal cancer increased compared with those in 2019. There was little difference between the proportions of postoperative complications and mortality in the three procedures between 2019 and 2020.
The number of endoscopic surgeries decreased in 2020 as a result of the COVID-19 pandemic. However, the procedures were performed safely in Japan.
本研究旨在利用国家临床数据库评估冠状病毒病（COVID-19）大流行对日本择期内镜手术的影响。
我们回顾性分析了腹腔镜胆囊切除术（LC）、腹腔镜远端胃切除术（LDG）和腹腔镜低位前切除术（LLAR）的临床病理因素及手术结果，并比较了2020年各手术每月的实施例数与2018年和2019年的情况。将各县的感染程度分为低感染组和高感染组。
2020年，LC（急性胆囊炎除外）的例数为76079例（为2019年的93.0%），LDG的例数为14271例（为2019年的85.9%），LLAR的例数为19570例（为2019年的88.1%）。尽管2020年机器人辅助LDG和LLAR病例数有所增加，但与2019年相比增长率较为平缓。各县感染程度不同的情况下病例数差异不大。LC、LDG和LLAR的例数在5月至6月减少，并逐渐恢复。2020年末，胃癌T4和N2病例的比例以及直肠癌T4病例的数量较2019年有所增加。2019年和2020年这三种手术的术后并发症比例和死亡率差异不大。
由于COVID-19大流行，2020年内镜手术例数减少。然而，这些手术在日本均安全实施。
