JMIR Perioper Med. 2022 Apr 29. doi: 10.2196/29045. Online ahead of print.
ABSTRACT
BACKGROUND: At the height of COVID 19 pandemic, the hepato-pancreato-biliary (HPB) unit had to reorganize surgical case volume due to rationing of healthcare resources. We report local audit evaluating the impact of COVID-19 on the HPB unit and its impact on HPB surgical oncology practice.
OBJECTIVE: The primary measure of the study was to review the impact of the COVID 19 pandemic on the HPB unit’s elective and emergency surgical cases. Secondary measures were to investigate the impact on HPB surgical oncology operative case volume.
METHODS: We performed a comparative audit of the HPB unit surgical case volume for January-June 2019 (baseline) and 2020 (COVID-19). Elective and emergency cases performed under general anesthesia were audited. Elective cases included hernia, gallbladder surgeries, liver and pancreatic resections. Emergency cases included cholecystectomies and laparotomies performed for general surgical indications. We excluded endoscopy and procedures done under local anaesthesia. The retrospective data collected in the two time periods were compared. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2000040265).
RESULTS: Elective surgical case volume decreased by 41.8% (n=351 (2019) vs. 204 (2020)) during the COVID-19 pandemic. Hernia surgery decreased by 63.9% (n=155 (2019) vs. 56 (2020), P=<.001) and cholecystectomy by 40.1% (n=157 (2019) vs. 94 (2020), P=.826). Liver and pancreatic resection volume increased by 16.7% (n=30 (2019) vs. 35 (2020), P=.004) and 111.1% (n=9 (2019) vs. 19 (2020), P=.001). The emergency surgical workload reduced by 40.9% (n=193 (2019) vs. 114 (2020)). The most significant reduction in emergency workload was observed in March, 41 to 23 cases (43.9%, P=.94), April 35 to 8 cases (77.1%, P =.01), and May 32 to 14 cases (56.3%, P=.39), however only April month showed statistically significant reduction in workload (P=.01).
CONCLUSIONS: Reallocation of resources due to the COVID-19 pandemic did not adversely impact elective HPB oncology work. With prudent measures in place, essential surgical services can be maintained during a pandemic.
CLINICALTRIAL: Chinese Clinical Trial Registry (ChiCTR2000040265).
PMID:35486909 | DOI:10.2196/29045
