Before and after COVID-19 pandemic: impact on hepatobiliary and pancreatic surgical services in a Singapore Tertiary Hospital.

Autor: Lim JSH; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Lim ZY; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Teo ZHT; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Wang B; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Tan YP; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Junnarkar SP; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Low JK; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Huey CWT; Department of General Surgery, Tan Tock Seng Hospital, Singapore., Shelat V; Department of General Surgery, Tan Tock Seng Hospital, Singapore.; Surgical Science Training Centre, Tan Tock Seng Hospital, Singapore.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2023 Dec; Vol. 93 (12), pp. 2904-2909. Date of Electronic Publication: 2023 Oct 27.
DOI: 10.1111/ans.18748
Abstrakt: Background: Reallocation of healthcare resources to prioritize the COVID-19 pandemic-related incremental healthcare needs resulted in longer waiting times for routine elective clinical services.
Aims: We aimed to analyze the effects of the pandemic on the hepatopancreatobiliary (HPB) unit's surgical workload.
Methods: The HPB unit's surgical workload for the months of January-June from 2019 to 2022 was extracted, retrospectively compared, and analyzed. This study was registered in ClinicalTrials.gov (NCT05572866) and complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Results: Benign elective surgeries were impacted adversely, with elective gallbladder operations decreasing by 45.2% (146 in 2019 vs 80 in 2020, p = 0.89) before slowly increasing to 120 cases in 2021 and rebounding to 179 cases in 2022 (p = 0.001). Elective oncology operations paradoxically increased, with liver resections rising by 12.9% (31 in 2019 vs 35 in 2020, p = 0.002) and maintaining 37 cases in 2021 (p = 0.0337) and 34 cases in 2022 (p = 0.69). Elective pancreatic resections increased by 171.4% (7 in 2019 vs 19 in 2020, p < 0.0001) and were maintained at 15 cases in 2021 (p = 0.013) and 18 cases in 2022 (p = 0.022). The overall emergency workload decreased from 2019 (n = 198) to 2020 (n = 129) to 2021 (n = 122) before recovering to baseline in 2022 (n = 184). The month-on-month volume generally showed similar trends compared to the other years except for February 2022 and May 2021.
Conclusion: This audit shows that despite large-scale disruption of the local healthcare system, essential surgeries can still proceed with careful resource planning by steadfast and vigilant clinical teams.
(© 2023 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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