Olszewska Natalia, Guzel Tomasz, Carus Thomas, Słodkowski Maciej
Department of General, Gastroenterological and Oncological Surgery, Central Clinical Hospital of Medical University of Warsaw, 02-091 Warsaw, Poland.
German-Polish Association of MiniInvasive Surgery, 02-091 Warsaw, Poland.
Life (Basel). 2024 Aug 16;14(8):1020. doi: 10.3390/life14081020.
This study aimed to objectively evaluate the impact of the gap in surgical practice caused by COVID-19 on surgical skill decay.
This retrospective cohort study enrolled 148 cases of adult patients who were qualified for elective or urgent laparoscopic cholecystectomy. This study compared the period of nine months before the pandemic outbreak and nine months after the end of the pandemic. We analyzed the duration of surgery, the number of intraoperative adverse events (IAEs), postoperative complications (PCs), and differences between the surgeries performed by residents and those performed by specialists.
The number of IAEs did not differ significantly between groups (after COVID-19 (AC) and before COVID-19 (BC)). A difficult gallbladder (DGB) was associated with an increased risk of IAEs during surgery in both groups (BC:OR = 2.94, = 0.049; AC:OR = 2.81, = 0.35). The multivariate analyses showed no significant differences in IAEs or PCs when the residents performed surgeries compared to specialists. The average duration of surgery was significantly longer in the post-pandemic group (BC-102.4 min vs. AC-119.9 min, = 0.024).
Measurable determinants of surgical skills are the duration of surgery and the number of intraoperative adverse events. By defining this indicators, our study objectively shows that the reduction in the volume of surgeries during COVID-19 resulted in a phenomenon known as surgical skill decay.
本研究旨在客观评估由新冠疫情导致的手术实践差距对外科手术技能衰退的影响。
这项回顾性队列研究纳入了148例符合择期或急诊腹腔镜胆囊切除术条件的成年患者。本研究比较了疫情爆发前九个月和疫情结束后九个月的情况。我们分析了手术时长、术中不良事件（IAEs）数量、术后并发症（PCs），以及住院医师与专科医生所做的手术之间的差异。
两组（新冠疫情后（AC）和新冠疫情前（BC））的IAEs数量没有显著差异。在两组手术中，困难胆囊（DGB）均与术中IAEs风险增加相关（BC：OR = 2.94，P = 0.049；AC：OR = 2.81，P = 0.35）。多因素分析显示，住院医师做手术时，与专科医生相比，IAEs或PCs没有显著差异。疫情后组的平均手术时长显著更长（BC - 102.4分钟 vs. AC - 119.9分钟，P = 0.024）。
手术技能的可衡量决定因素是手术时长和术中不良事件数量。通过定义这些指标，我们的研究客观地表明，新冠疫情期间手术量的减少导致了一种被称为手术技能衰退的现象。
