Kumar Ravikant, Jha Sanjeev K, Roy Saumyaleen, Dayal Vishwa M
Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2023 Jul 3;15(7):e41315. doi: 10.7759/cureus.41315. eCollection 2023 Jul.
Background To contain the spread of infection and reduce the burden on healthcare infrastructure, many countries globally adopted a lockdown strategy during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Hospitals were converted to dedicated coronavirus disease 2019 (COVID-19) centers, and non-COVID-19 patients were intervened on a triage basis. During this time, only emergency procedures were performed. The impact of this lockdown strategy during the first wave of the SARS-CoV-2 pandemic on various gastrointestinal endoscopy interventions remains unknown. Methodology In this retrospective, observational study conducted in the Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar from March 25 to September 30, 2020, data related to clinical profile, indication, and endoscopic interventions performed in reverse transcriptase-polymerase chain reaction (RT-PCR)-negative patients with the use of personal protective kits were analyzed and compared with the historical controls. Results A total of 2,282 patients were admitted and 422 endoscopic procedures were performed during the six-month study period with an intervention rate of 18.49%. The most common procedure was upper gastrointestinal endoscopy (228, 58.13%), followed by endoscopic retrograde cholangiopancreatography (ERCP) (88, 22.50%). Chronic liver disease (CLD) (144 patients) followed by malignancy (111 patients) were the most common diagnosis. During the first phase of the lockdown (March to May), only 52 procedures were performed (52 vs. 506). None of the patients underwent endoscopic ultrasound. In 2019, 4,501 patients were admitted and 1,224 procedures were performed with an intervention rate of 27.19 (p < 0.0001). None of the staff of the Department of Gastroenterology developed symptomatic SARS-CoV-2 infection during this period. Conclusions There was a significant drop in endoscopic procedures during the lockdown and most of the esophagoduodenoscopy procedures were done for CLD and ERCP for biliary tract malignancy. Endoscopic procedures done on RT-PCR for COVID-19-negative patients were safe using personal protective kits.
背景 为遏制感染传播并减轻医疗基础设施负担,全球许多国家在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行期间采取了封锁策略。医院被改造成专门的2019冠状病毒病(COVID-19)中心,非COVID-19患者按分诊原则进行干预。在此期间,仅进行急诊手术。SARS-CoV-2大流行第一波期间这种封锁策略对各种胃肠内镜干预的影响尚不清楚。
方法 在2020年3月25日至9月30日于比哈尔邦巴特那英迪拉·甘地医学科学研究所胃肠病科进行的这项回顾性观察研究中,分析了使用个人防护装备对逆转录聚合酶链反应(RT-PCR)阴性患者进行的临床资料、适应证及内镜干预相关数据,并与历史对照进行比较。
结果 在为期6个月的研究期间,共收治2282例患者,进行了422例内镜手术,干预率为18.49%。最常见的手术是上消化道内镜检查(228例,58.13%),其次是内镜逆行胰胆管造影(ERCP)(88例,22.50%)。最常见的诊断是慢性肝病(CLD)(144例患者),其次是恶性肿瘤(111例患者)。在封锁的第一阶段(3月至5月),仅进行了52例手术(52例对506例)。没有患者接受内镜超声检查。2019年,收治4501例患者,进行了1224例手术,干预率为27.19(p<0.0001)。在此期间,胃肠病科工作人员均未出现有症状的SARS-CoV-2感染。
结论 封锁期间内镜手术显著减少,大多数食管十二指肠镜检查手术是针对CLD进行的,ERCP手术是针对胆道恶性肿瘤进行的。使用个人防护装备对COVID-19阴性患者进行RT-PCR检测后进行的内镜手术是安全的。