Laparoscopic vs open surgery during the COVID-19 pandemic: what are the risks?
Ann R Coll Surg Engl
; 103(5): 354-359, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1121418
ABSTRACT
INTRODUCTION:
The initial intercollegiate surgical guidance from the UK during the COVID-19 pandemic resulted in significant changes to practice. Avoidance of laparoscopy was recommended, to reduce aerosol generation and risk of virus transmission. Evidence on the safety profile of laparoscopy during the pandemic is lacking. This study compares patient outcomes and risk to staff from laparoscopic and open gastrointestinal operations during the COVID-19 pandemic.METHODS:
Single-centre retrospective study of gastrointestinal operations performed during the peak of the COVID-19 pandemic. Demographic, comorbidity, perioperative and survival data were collected from electronic medical records and supplemented with patient symptoms reported at telephone follow up. Outcomes assessed were patient mortality, illness among staff, patient COVID-19 rates, length of hospital stay and postdischarge symptomatology.RESULTS:
A total of 73 patients with median age of 56 years were included; 55 (75%) and 18 (25%) underwent laparoscopic and open surgery, respectively. All-cause mortality was 5% (4/73), was related to COVID-19 in all cases, with no mortality after laparoscopic surgery. A total of 14 staff members developed COVID-19 symptoms within 2 weeks, with no significant difference between laparoscopic and open surgery (10 vs 4; p=0.331). Median length of stay was shorter in the laparoscopic versus the open group (4.5 vs 9.9 days; p=0.011), and postdischarge symptomatology across 15 symptoms was similar between groups (p=0.135-0.814).CONCLUSIONS:
With appropriate protective measures, laparoscopic surgery is safe for patients and staff during the COVID-19 pandemic. The laparoscopic approach maintains an advantage of shorter length of hospital stay compared with open surgery.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Digestive System Surgical Procedures
/
Laparoscopy
/
Infectious Disease Transmission, Patient-to-Professional
/
Gastrointestinal Diseases
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Country/Region as subject:
Europa
Language:
English
Journal:
Ann R Coll Surg Engl
Year:
2021
Document Type:
Article
Affiliation country:
Rcsann.2020.7067
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