英国鼻学会国家COVID-19研究:恢复选择性手术

S. Mahalingam, R. Green, M. Slim, A. Alatsatianos, Y. Ramakrishnan, B. Stew, C. Hopkins
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引用次数: 1

摘要

背景:在第一波SARS-CoV-2大流行之后,随着选择性服务的恢复,英国鼻科学学会和初级委员会开展了一项全国前瞻性研究,以评估和优化手术的安全性和有效性。方法:在研究期间(2020年6月1日至8月14日)从英国(不包括北爱尔兰)的111个中心收集了1063例病例的数据,并进行了为期三周的随访,以评估患者和工作人员中是否存在SARS-CoV-2病例。结果:89.2%的手术在英国进行,90.6%的患者有最小的合并症(ASA 1级或2级),98.4%的患者在手术前已知为COVID阴性,其中大多数(99.8%)仅通过病毒PCR进行调查。最常见的术前保护形式是自我隔离14天(占82.5%)。32.6%的病例在替代的剧院环境中进行,5.3%的私营部门用于NHS患者。21.6%的手术使用了不熟悉的麻醉团队,19.2%的手术使用了不熟悉的手术室团队。当在一个不同的剧院环境中操作时,不熟悉的剧院工作人员或麻醉师的可能性更高。24.2%的病例中受训人员不在手术室。64.1%的病例手术外科医生穿戴全套PPE(个人防护装备)。在手术后的三周内,没有报告患者或工作人员患上SARS-CoV-2。19.7%的病例报告了术中挑战,主要与沟通障碍(8.8%)或视力障碍(6.9%)有关。当不熟悉的戏剧团队在场时,报告的挑战机会更高。结论:该数据表明,总体而言,恢复鼻外科选择性服务是安全的,患者或工作人员中没有报告SARS-CoV-2病例。我们必须考虑在陌生环境中与外科和/或麻醉团队一起操作的挑战,以及对训练的影响。
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The British Rhinology Society National COVID-19 Study: Resuming Elective Surgery
Background: As elective services resumed in the aftermath of the first wave of the SARS-CoV-2 pandemic, the British Rhinology Society and Juniors Committees carried out a national prospective study in order to assess and optimise safety and efficacy of surgery. Methodology: Data from 1063 cases was collected from 111 centres in the United Kingdom (excluding Northern Ireland) within the study period (1st June – 14th August 2020), and a three week follow-up period to assess whether there were any cases of SARS-CoV-2 amongst patients and staff. Results: 89.2% of procedures took place in England. 90.6% of patients had minimal comorbidities (ASA Grade 1 or 2). 98.4% of patients were known to have a COVID negative status prior to surgery, with the majority (99.8%) investigated through Viral PCR alone. The most common form of pre-operative shielding was to self-isolate for 14 days (82.5% of cases). 32.6% of cases were performed in an alternative theatre environment, and in 5.3% the private sector was used for NHS patients. In 21.6% of procedures, unfamiliar anaesthetic teams were used, and in 19.2% unfamiliar theatre teams. There was a higher probability of unfamiliar theatre staff or anaesthetist, when operating in an alternative theatre environment. Trainees were not present in theatre in 24.2% of cases. Full PPE (Personal Protective Equipment) was worn by the operating surgeon in 64.1% of cases. No patients or staff were reported to have developed SARS-CoV-2 in the three week period following surgery. Intra-operative challenges were reported in 19.7% of cases and were primarily associated with impaired communication (8.8%) or impaired vision (6.9%). There was a higher chance of challenges reported when unfamiliar theatre teams were present. Conclusions: This data suggests that overall, the resumption of rhinological elective services has been performed safely with no cases of SARS-CoV-2 reported in patients or staff. We must consider the challenges of operating in unfamiliar environments together with surgical and/or anaesthetic teams, as well as the impact on training.
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