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应对新冠疫情后的胆囊切除术等候名单:我们是否迎接了挑战?

Tackling a Post-COVID-19 Cholecystectomy Waiting List: Are We Meeting the Challenge?

机构信息

University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham B9 5SS, UK.

出版信息

Medicina (Kaunas). 2023 Oct 21;59(10):1872. doi: 10.3390/medicina59101872.

Abstract

: The COVID-19 pandemic has led to a tremendous backlog in elective surgical activity. Our hospital trust adopted an innovative approach to dealing with elective waiting times for cholecystectomy during the recovery phase from COVID-19. This study aimed to evaluate trends in overall cholecystectomy activity and the effect on waiting times. : A prospective observational study was undertaken, investigating patients who received a cholecystectomy at a large United Kingdom hospital trust between February 2021 and February 2022. There were multiple phased strategies to tackle a 533-patient waiting list: private sector, multiple sites including emergency operating, mobile theatre, and seven-day working. The correlation of determination (R) and Kruskal-Wallis analysis were used to evaluate trends in waiting times across the study period. : A total of 657 patients underwent a cholecystectomy. The median age was 49 years, 602 (91.6%) patients had an ASA of 1-2, and 494 (75.2%) were female. A total of 30 (4.6%) patients were listed due to gallstone pancreatitis, 380 (57.8%) for symptomatic cholelithiasis, and 228 (34.7%) for calculous cholecystitis. Median waiting times were reduced from 428 days (IQR 373-508) to 49 days (IQR 34-96), R = 0.654, < 0.001. For pancreatitis specifically, waiting times had decreased from a median of 218 days (IQR 139-239) to 28 (IQR 24-40), R = 0.613, < 0.001. : This study demonstrates the methodology utilised to safely and effectively tackle the cholecystectomy waiting list locally. The approach utilised here has potential to be adapted to other units or similar operation types in order to reduce elective waiting times.

摘要

: COVID-19 大流行导致择期手术活动积压严重。我们的医院信托机构在从 COVID-19 恢复阶段采用了一种创新的方法来处理胆囊切除术的择期等待时间。本研究旨在评估胆囊切除术整体活动趋势及其对等待时间的影响。: 进行了一项前瞻性观察研究,调查了 2021 年 2 月至 2022 年 2 月期间在英国一家大型医院信托机构接受胆囊切除术的患者。有多种分阶段策略来解决 533 名等待名单患者:私营部门、包括急诊手术室、移动剧院和每周七天工作在内的多个地点。使用决定系数(R)和 Kruskal-Wallis 分析来评估整个研究期间等待时间的趋势。: 共有 657 名患者接受了胆囊切除术。中位年龄为 49 岁,602 名(91.6%)患者的 ASA 为 1-2,494 名(75.2%)为女性。共有 30 名(4.6%)患者因胆石性胰腺炎、380 名(57.8%)因有症状胆石症和 228 名(34.7%)因结石性胆囊炎而被列入名单。中位等待时间从 428 天(IQR 373-508)缩短至 49 天(IQR 34-96),R=0.654,<0.001。具体来说,胰腺炎的等待时间从中位数 218 天(IQR 139-239)缩短至 28 天(IQR 24-40),R=0.613,<0.001。: 本研究展示了在当地安全有效地处理胆囊切除术等待名单所使用的方法。这里采用的方法有可能被其他单位或类似手术类型采用,以减少择期等待时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84b/10608591/826faa7b68ce/medicina-59-01872-g001.jpg

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