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COVID-19 危机期间的外科挑战:罗马尼亚腹股沟疝治疗的对比研究。

Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania.

机构信息

Abdominal Surgery and Phlebology Research Center, "Victor Babeş" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

First Surgery Clinic, "Pius Brinzeu" Clinical Emergency Hospital, 300723 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2024 Nov 6;60(11):1825. doi: 10.3390/medicina60111825.

Abstract

: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and outcomes of IHR procedures. : A retrospective review was conducted on 604 patients who underwent IHR over six years, spanning pre-pandemic, pandemic, and post-pandemic periods. Data on patient demographics, type of surgical procedure (elective or emergency), use of mesh, surgical duration, hospitalization period, and postoperative outcomes were analyzed across the three time frames. : Patient age remained consistent across the three periods, but a significant increase in female patients was observed during and after the pandemic ( < 0.001). Elective IHR surgeries significantly decreased during the pandemic ( < 0.001), paralleled by an increase in emergency cases ( = 0.004). In the post-pandemic period, elective surgeries rebounded, while emergency interventions declined (21.9% vs. 10.3%). Mesh repair usage increased notably in the post-pandemic phase ( < 0.001). Although surgeries took longer during the pandemic ( < 0.001), both total and postoperative hospital stays were reduced during and after the pandemic ( < 0.001). Minimal postoperative complications were reported throughout, with only one mortality during the pandemic. : This study highlights the need for robust healthcare strategies to maintain elective surgical care during global crises, as delays in IHR may elevate risks for complications like hernia incarceration and strangulation.

摘要

: COVID-19 大流行扰乱了全球的医疗体系,导致择期手术(包括腹股沟疝修补术,IHR)被推迟,因为医疗资源优先用于重症监护。本研究旨在评估大流行对 IHR 程序发生率和结果的影响。 : 对 604 例在六年内接受 IHR 的患者进行了回顾性研究,跨越了大流行前、大流行中和大流行后三个时期。分析了三个时期的患者人口统计学数据、手术类型(择期或急诊)、使用网片、手术持续时间、住院时间和术后结果。 : 三个时期患者年龄保持一致,但大流行期间和之后女性患者显著增加( < 0.001)。大流行期间择期 IHR 手术显著减少( < 0.001),同时急诊病例增加( = 0.004)。大流行后,择期手术反弹,而急诊干预减少(21.9%比 10.3%)。在后疫情时期,网片修复的使用显著增加( < 0.001)。尽管大流行期间手术时间延长( < 0.001),但大流行期间和之后的总住院时间和术后住院时间均缩短( < 0.001)。报告的术后并发症很少,只有一名患者在大流行期间死亡。 : 本研究强调了在全球危机期间维持择期手术护理的强有力的医疗策略的必要性,因为 IHR 的延迟可能会增加疝嵌顿和绞窄等并发症的风险。

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