Lee Sung Ryul
Department of Surgery, Damsoyu Hospital, Seoul, Korea.
Ann Surg Treat Res. 2024 Oct;107(4):221-228. doi: 10.4174/astr.2024.107.4.221. Epub 2024 Sep 30.
During the coronavirus disease 2019 (COVID-19) pandemic, frequent perioperative interactions between patients and medical staff increased the risk of nosocomial infections. Total 1-day perioperative completion (TODPC) involves conducting preoperative evaluations, performing the operation, and facilitating discharge within a single day. This study aimed to evaluate the safety of TODPC in reducing perioperative contact by utilizing online and telephone appointment systems for inguinal hernia (IH) repairs.
In this retrospective cohort study, we analyzed data from patients who underwent IH repairs. The study was divided into 2 periods relative to the COVID-19 pandemic: 18 months pre-pandemic (Group 1, September 2018-February 2020) and 18 months post-pandemic onset (Group 2, March 2020-August 2021). We compared the frequency of TODPC, daycare surgeries (which require hospital visits for preoperative evaluations and admission on the day of surgery), preoperative contacts, hernia types, incarcerations, organ resections, and instances of COVID-19 transmission among medical staff and patients.
The study included 5,728 participants, comprising 4,614 pediatric and 1,114 adult patients. The rate of TODPC implementation was higher in Group 2 than in Group 1 (91.0% 75.0%, P < 0.001). The incidence of organ resections was low and did not differ significantly between the 2 groups. Throughout the study, there were no reported nosocomial COVID-19 infections among patients, parents, caregivers, or medical staff.
TODPC for IH repair was a safe strategy for minimizing the need for organ resections and reducing the risk of mass COVID-19 infections during the pandemic period from March 2020 to August 2021.
在2019年冠状病毒病(COVID-19)大流行期间,患者与医护人员在围手术期频繁接触增加了医院感染风险。全1天围手术期完成(TODPC)包括进行术前评估、实施手术以及在一天内促成出院。本研究旨在通过利用在线和电话预约系统进行腹股沟疝(IH)修补术,评估TODPC在减少围手术期接触方面的安全性。
在这项回顾性队列研究中,我们分析了接受IH修补术患者的数据。该研究相对于COVID-19大流行分为2个时期:大流行前18个月(第1组,2018年9月至2020年2月)和大流行开始后18个月(第2组,2020年3月至2021年8月)。我们比较了TODPC的频率、日间手术(需要到医院进行术前评估并在手术当天入院)、术前接触、疝类型、嵌顿、器官切除以及医护人员和患者之间COVID-19传播的情况。
该研究纳入了5728名参与者,包括4614名儿科患者和1114名成年患者。第2组TODPC的实施率高于第1组(91.0%对75.0%,P<0.001)。器官切除的发生率较低,两组之间无显著差异。在整个研究过程中,患者、家长、护理人员或医护人员中均未报告有医院获得性COVID-19感染。
2020年3月至2021年8月大流行期间,IH修补术的TODPC是一种安全策略,可将器官切除需求降至最低,并降低大规模COVID-19感染的风险。