Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" - IRCCS, 00168, Rome, Italy.
Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Updates Surg. 2024 Jun;76(3):1073-1083. doi: 10.1007/s13304-024-01771-0. Epub 2024 Feb 13.
The COVID-19 pandemic has limited the availability of healthcare resources for non-COVID patients and decreased elective surgeries, including thyroidectomy. Despite the prioritization of surgical procedures, it has been reported that thyroidectomy for thyroid cancer (TCa) was adversely impacted. We assessed the impact of the pandemic on the surgical activities of two high-volume referral centers.
Patients operated at two National Referral Centers for Thyroid Surgery between 03/01/2020 and 02/28/2021 (COVID-19 period) were included (P-Group). The cohort was compared with patients operated at the same Centers between 03/01/2019 and 02/29/2020 (pre-COVID-19 pandemic) (C-Group).
Overall, 7017 patients were included: 2782 in the P-Group and 4235 in the C-Group. The absolute number of patients with TCa was not significantly different between the two groups, while the rate of malignant disease was significantly higher in the P-Group (1103/2782 vs 1190/4235) (P < 0.0001). Significantly more patients in the P-Group had central (237/1103 vs 232/1190) and lateral (167/1103 vs 140/1190) neck node metastases (P = 0.001). Overall, the complications rate was significantly lower (11.9% vs 15.1%) and hospital stay was significantly shorter (1.7 ± 1.5 vs 1.9 ± 2.2 days) in the P-Group (P < 0.05).
The COVID-19 pandemic significantly decreased the overall number of thyroidectomies but did not affect the number of operations for TCa. Optimization of management protocols, due to limited resource availability for non-COVID patients, positively impacted the complication rate and hospital stay.
COVID-19 大流行限制了非 COVID 患者的医疗资源可及性，并减少了择期手术，包括甲状腺切除术。尽管优先考虑手术程序，但据报道，甲状腺癌（TCa）的甲状腺切除术受到了不利影响。我们评估了大流行对两个高容量转诊中心手术活动的影响。
在 2020 年 3 月 1 日至 2021 年 2 月 28 日期间（COVID-19 期间）在两个国家甲状腺手术转诊中心接受手术的患者被纳入（P 组）。该队列与在同一中心于 2019 年 3 月 1 日至 2020 年 2 月 29 日（COVID-19 大流行前）接受手术的患者进行了比较（C 组）。
总体而言，共有 7017 名患者入组：P 组 2782 例，C 组 4235 例。两组 TCa 患者的绝对数量无显著差异，但 P 组恶性疾病的发生率明显更高（1103/2782 比 1190/4235）（P<0.0001）。P 组更多的患者有中央（237/1103 比 232/1190）和侧颈部淋巴结转移（167/1103 比 140/1190）（P=0.001）。总体而言，P 组的并发症发生率明显较低（11.9%比 15.1%），住院时间明显较短（1.7±1.5 比 1.9±2.2 天）（P<0.05）。
COVID-19 大流行显著减少了甲状腺切除术的总数，但并未影响 TCa 的手术数量。由于非 COVID 患者的资源可用性有限，管理方案的优化对并发症发生率和住院时间产生了积极影响。
