Tang Anthony, Abdallah Hussein M, Chang Yue-Fang, Zenonos Georgios A, Gardner Paul A, Choby Garret W, Wang Eric W, Snyderman Carl H
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Pituitary. 2024 Dec;27(6):986-991. doi: 10.1007/s11102-024-01435-7. Epub 2024 Jul 24.
The COVID-19 pandemic caused significant disruption to the surgical care of patients. The aim of this study was to analyze the impact of the pandemic on endoscopic endonasal surgery (EES) for patients with a pituitary adenoma.
Patients from 2015 to 2022 that had EES for a pituitary adenoma were included in this study. Patients were separated into pre-COVID (January 2015-March 2020) and COVID (March 2020-September 2022) groups. Univariate analysis was done using chi-square, fisher exact tests, and t-tests to compare groups.
This study included 492 patients that had EES for their pituitary adenoma. There were 314 patients in the pre-COVID group and 178 patients in the COVID group. Patients in the COVID group had a higher risk analysis index (RAI) frailty score (15 ± 10 pre-COVID vs. 20 ± 9 COVID, P < 0.001) and a higher American Society of Anesthesiology (ASA) physical status score (3 or 4) (72.0% pre-COVID vs. 81.9% COVID, P = 0.02). There were significantly more macroadenoma cases (87.6% pre-COVID vs. 94.4% COVID, P = 0.02) and extrasellar surgical approaches (45.2% pre-COVID vs. 61.2% COVID, P < 0.001) during COVID. There was no significant difference in length of stay (LOS) and readmission rates between groups.
Patients that presented during the pandemic tended to be more frail, have more comorbidities, and require additional extrasellar surgical approaches. Despite changes in clinical presentation and operative management, the LOS and readmission rate remained stable during COVID, supporting the safety of this procedure during the recent pandemic.
新型冠状病毒肺炎（COVID-19）大流行对患者的外科治疗造成了重大干扰。本研究的目的是分析该大流行对垂体腺瘤患者鼻内镜手术（EES）的影响。
本研究纳入了2015年至2022年接受垂体腺瘤EES的患者。患者被分为COVID前组（2015年1月至2020年3月）和COVID组（2020年3月至2022年9月）。使用卡方检验、Fisher精确检验和t检验进行单因素分析以比较各组。
本研究纳入了492例接受垂体腺瘤EES的患者。COVID前组有314例患者，COVID组有178例患者。COVID组患者的风险分析指数（RAI）虚弱评分更高（COVID前为15±10，COVID组为20±9，P<0.001），美国麻醉医师协会（ASA）身体状况评分更高（3或4级）（COVID前为72.0%，COVID组为81.9%，P=0.02）。在COVID期间，大腺瘤病例（COVID前为87.6%，COVID组为94.4%，P=0.02）和鞍外手术入路（COVID前为45.2%，COVID组为61.2%，P<0.001）明显更多。两组之间的住院时间（LOS）和再入院率没有显著差异。
在大流行期间就诊的患者往往更虚弱，合并症更多，并且需要额外的鞍外手术入路。尽管临床表现和手术管理发生了变化，但在COVID期间LOS和再入院率保持稳定，支持了在最近的大流行期间该手术的安全性。
