Akagi Tomonori, Endo Hideki, Inomata Masafumi, Shiroshita Hidefumi, Yamaguchi Shigeki, Eguchi Susumu, Wada Norihito, Kurokawa Yukinori, Seki Yosuke, Sakai Yoshiharu, Yamamoto Hiroyuki, 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. 2024 Jan 28;8(3):521-529. doi: 10.1002/ags3.12776. eCollection 2024 May.
The COVID-19 outbreak made conventional medical care impossible, forcing changes in both healthcare providers and patients. In Japan, COVID-19 infection began spreading in earnest in 2020 and exploded in 2021. There was concern that the medical impact of COVID-19 in 2021 would differ from that in 2020. We aimed to clarify the impact of COVID-19 on mortality and anastomotic leakage in laparoscopic surgery for gastric cancer and rectal cancer in Japan using the National Clinical Database (NCD).
We collected data from patients who underwent laparoscopic distal gastrectomy (LDG) and laparoscopic low anterior resection (LLAR) from January 2018 to December 2021 from the NCD, a web-based surgical registration system in Japan. The number of surgical cases, monthly incidence of mortality and morbidity (anastomotic leakage), standardized mortality ratio (SMR), and standardized morbidity-leakage ratio (SMLR [ratio of observed patients to expected patients calculated using the risk calculator established in the NCD]) were evaluated.
The numbers of LDG and LLAR cases continued to decline in the first year of the pandemic in 2020 and were as low in 2021 as in 2020. Although the numbers of robot-assisted LDG and LLAR cases increased, the growth rate was lower than the rate of increase prior to the pandemic. Mortality and anastomotic leakage, two of the most important complications, as assessed by SMR and SMLR, did not worsen during the pandemic in comparison to the pre-pandemic period.
Laparoscopic surgeries were performed safely in Japan and were not affected by the COVID-19 pandemic.
新型冠状病毒肺炎（COVID-19）疫情使得常规医疗护理无法进行，迫使医疗服务提供者和患者都做出改变。在日本，COVID-19感染于2020年开始真正蔓延，并在2021年激增。人们担心2021年COVID-19对医疗的影响会与2020年有所不同。我们旨在利用国家临床数据库（NCD）阐明COVID-19对日本胃癌和直肠癌腹腔镜手术中死亡率和吻合口漏的影响。
我们从NCD（日本一个基于网络的手术登记系统）收集了2018年1月至2021年12月期间接受腹腔镜远端胃切除术（LDG）和腹腔镜低位前切除术（LLAR）的患者的数据。评估了手术病例数、死亡率和发病率（吻合口漏）的月度发生率、标准化死亡率（SMR）以及标准化发病-漏率（SMLR[使用NCD中建立的风险计算器计算的观察患者与预期患者的比率]）。
在2020年疫情的第一年，LDG和LLAR病例数持续下降，2021年与2020年一样低。尽管机器人辅助的LDG和LLAR病例数有所增加，但其增长率低于疫情前的增长速度。通过SMR和SMLR评估的两个最重要的并发症——死亡率和吻合口漏，在疫情期间与疫情前相比并未恶化。
在日本，腹腔镜手术安全进行，且未受COVID-19疫情影响。
