Puia Aida, Feier Catalin Vladut Ionut, Gaborean Vasile, Bodea Raluca, Graur Florin, Zaharie Florin, Al-Hajjar Nadim, Puia Ion Cosmin
Department of Community Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.
First Discipline of Surgery, Department X-Surgery, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2., 300041 Timisoara, Romania.
Medicina (Kaunas). 2024 Nov 22;60(12):1924. doi: 10.3390/medicina60121924.
: This study evaluated the impact of the COVID-19 pandemic on the surgical management of pancreatic ductal adenocarcinoma (PDAC) at a tertiary care hospital in Romania. The objective was to compare surgical volumes, tumor characteristics, and patient outcomes across three periods: pre-COVID, pandemic, and post-COVID. : A retrospective analysis of 622 PDAC patients who underwent surgery between February 2018 and February 2024 was conducted. The key variables analyzed included tumor size, type of surgery (curative vs. palliative), use of neoadjuvant therapy, postoperative complications, and ICU monitoring, among others. : During the pandemic, there was a 25% decrease in surgical interventions compared the number performed during the pre-pandemic period, with a significant increase in the number of patients undergoing surgical intervention following neoadjuvant treatment ( = 0.009) in the post-pandemic period. Post-pandemic, surgical volumes increased by 10%, and tumor sizes were smaller ( = 0.029). Postoperative outcomes, such as complications, remained stable across the periods, but intensive care unit monitoring increased significantly during the pandemic and post-pandemic periods. Hospital stay durations were significantly shorter during and after the pandemic ( < 0.05). : The COVID-19 pandemic led to delays in PDAC surgeries, but post-pandemic improvements in surgical volumes and early diagnosis are evident; however, further optimization of screening and treatment protocols is essential for improving patient outcomes.
本研究评估了新冠疫情对罗马尼亚一家三级医疗医院胰腺导管腺癌（PDAC）手术治疗的影响。目的是比较三个时期的手术量、肿瘤特征和患者预后：新冠疫情前、疫情期间和疫情后。
对2018年2月至2024年2月期间接受手术的622例PDAC患者进行了回顾性分析。分析的关键变量包括肿瘤大小、手术类型（根治性与姑息性）、新辅助治疗的使用、术后并发症和重症监护监测等。
在疫情期间，与疫情前相比，手术干预减少了25%，疫情后接受新辅助治疗后进行手术干预的患者数量显著增加（P = 0.009）。疫情后，手术量增加了10%，肿瘤尺寸变小（P = 0.029）。术后结局，如并发症，在各时期保持稳定，但在疫情期间和疫情后，重症监护监测显著增加。疫情期间及之后住院时间显著缩短（P < 0.05）。
新冠疫情导致PDAC手术延迟，但疫情后手术量和早期诊断有明显改善；然而，进一步优化筛查和治疗方案对于改善患者预后至关重要。
