Jednodnevna kirurgija tijekom pandemije COVID-19

Filip Jurić, Anko Antabak, Ivonne Žgaljardić, Fran Štampalija, Ana Bosak Veršić

Cilj rada je ustanoviti trend kirurškog liječenja djece kroz jednodnevnu kirurgiju (JDK) Klinike za dječje bolesti Zagreb tijekom pandemije COVID-19 uspoređujući podatke iz po dvije predpandemijske i pandemijske godine (2018. – 2021.). U ovu retrospektivnu studiju uključena su operirana djeca Klinike za dječje bolesti Zagreb u razdoblju od početka 2018. do kraja 2021. godine. Analizirana su djeca operirana kroz jednodnevnu kirurgiju u odnosu na one bolnički liječene (boravak preko 24 sata) po najčešćim operacijskim zahvatima specifičnim za dječju kirurgiju (preponske kile, varikokele, retencije testisa). Ukupno je 2018. godine na Klinici za kirurgiju operativno liječeno 4.188 djece, od čega po postulatima jednodnevne kirurgije njih 29%. U 2019. godini operirano je ukupno 4.370 djece, od čega je njih 31,6% operirano kroz JDK, a 2020. godine od 2.724 djece njih 40,6% kroz JDK. Tijekom 2021. operirano je ukupno 3.036 pacijenata, od čega kroz JDK njih 52,14%. Od operacija ingvinalne hernije u JDK načinjeno je 2018. 49%, 2019. 47,1%, 2020. 58,1%, a 2021. 76,8% od ukupnog broja djece liječene ovom metodom. Od operacija retencija testisa u JDK načinjeno je 2018. 1%, 2019. 9,4%, 2020. 53,2%, a 2021. 73,2%. U 2018. i 2019. godini sva su djeca s dijagnozom varikokele liječena bolnički, 2020. udio operiranih kroz JDK bio je 70,7%, a u 2021. 96,8%. Rezultati pokazuju kako u periodu 2018. – 2021. godine udio operacija djece kroz Odjel jednodnevne kirurgije raste. Neobična situacija 2020. godine u Gradu Zagrebu (pandemija i potresom reduciran posteljni bolnički kapacitet) prinudila je kirurge da izmijene tradicionalni pristup i prihvate jednodnevnu dječju kirurgiju kao siguran i učinkovit pristup liječenju.

This study aimed to determine the trend of surgical treatment of patients through the Day Surgery Department (DSD) at the Children’s Hospital Zagreb during the COVID-19 pandemic, comparing data from the pre-pandemic and the first two pandemic years. For this retrospective study, all patients of the Clinic for pediatric surgery operated on between the beginning of 2018 and the end of 2021 were taken into account. Patients operated through day surgery were compared to those who were treated as inpatients. We also compared the ratio of day surgery to inpatient care for patients who underwent common pediatric surgical procedures, including inguinal
hernias, testicular retention, and varicocele. Furthermore, we investigated the percentage and causes of unplanned hospitalizations in patients treated through day surgery. In 2018, a total of 4,188 children were surgically treated at the Surgery Clinic, 29% of whom underwent surgery according to the principles of day surgery. In 2019, a total of 4,370 children were operated on, with 31.6% of them undergoing day surgery. In 2020, there were 2,724 patients, of which 40.6% underwent day surgery. During 2021, a total of 3,036 patients were operated on, 52.1% of whom underwent day surgery. In 2018 and 2019, inguinal hernia operations were primarily performed as inpatient procedures, with 49% and 47.1% respectively carried out through DSD. By 2020, this shifted, with 58.1% of hernioplasties performed through DSD, and by 2021, this figure increased to 76.%. In 2019, only 9.4% of the testicular retention operations were performed through DSD, while the percentage of those operated through DSD increased significantly in 2020 to 53.2% and to 73.2% in 2021. All patients diagnosed with varicocele in 2018 and 2019 were treated as inpatients. In 2020, 70.7% were operated on through day surgery, and in 2021, this percentage rose to 96.8%. Despite the expected decrease in the number of patients during the first year of the pandemic, the proportion of patients operated on through the Department of Day Surgery is increasing throughout the years. The difficult situation forced surgeons to change their traditional mindset and accept day surgery as a safe and effective approach to treating elective surgical patients.