Background Swedish healthcare has been reorganised during the COVID-19 pandemic, affecting the availability of surgery for benign conditions. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgery in a Swedish healthcare region. Methods Using procedure codes, data from inguinal and ventral hernia procedures performed at the three hospitals in Jönköping Region, Sweden, from March 1st 2019 to January 31st 2021, were retrieved from a medical database. The cohort was divided into two groups: the COVID-19 group (March 1st 2020–January 31st 2021) and the control group (March 1st 2019–January 31st 2020). Demographic and preoperative data, hernia type, perioperative findings, and type of surgery were analysed. Results A total 1329 patients underwent hernia surgery during the study period; 579 were operated during the COVID-19 period and 750 during the control period. The number of emergency ventral hernia repairs increased during the COVID-19 period, but no difference in inguinal hernia repair rate was seen. The characteristics of patients that underwent hernia repair were similar in the two groups. Moreover, the decrease in elective ventral hernia repair rate during the COVID-19 period did not result in a higher risk for strangulation. Conclusion There is no evidence to suggest that the decrease in the number of elective ventral hernia repairs during the COVID-19 period had any impact on the risk for strangulation. Indications for surgery in patients with a symptomatic ventral or inguinal hernia should be carefully evaluated. Studies with greater power and longer follow-up are needed to gain a full understanding of the effects of the COVID-19 pandemic on hernia surgery.
BackgroundSwedish healthcare has been reorganised during the COVID-19 pandemic, affecting the availability of surgery for benign conditions. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgery in a Swedish healthcare region.MethodsUsing procedure codes, data from inguinal and ventral hernia procedures performed at the three hospitals in Jönköping Region, Sweden, from March 1st 2019 to January 31st 2021, were retrieved from a medical database. The cohort was divided into two groups: the COVID-19 group (March 1st 2020 - January 31st 2021) and the control group (March 1st 2019 - January 31st 2020). Demographic and preoperative data, hernia type, perioperative findings, and type of surgery were analysed.ResultsA total 1329 patients underwent hernia surgery during the study period; 579 were operated during the COVID-19 period and 750 during the control period. The number of emergency ventral hernia repairs increased during the COVID-19 period, but no difference in inguinal hernia repair rate was seen. The characteristics of patients that underwent hernia repair were similar in the two groups. Moreover, the decrease in elective ventral hernia repair rate during the COVID-19 period did not result in a higher risk for strangulation.ConclusionThere is no evidence to suggest that the decrease in the number of elective ventral hernia repairs during the COVID-19 period had any impact on the risk for strangulation. Indications for surgery in patients with a symptomatic ventral or inguinal hernia should be carefully evaluated. Studies with greater power and longer follow-up are needed to gain a full understanding of the effects of the COVID-19 pandemic on hernia surgery.
Aim During the COVID-19 pandemic, Swedish health care centers were restructured. This was accompanied by changes in the surgical programme. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgeries in a Swedish health-care region. Material and Methods This was a retrospective, observational cohort study. Data from inguinal and ventral hernia surgeries were retrieved from a medical database using procedure codes from all three hospitals in Region Jönköping County from March 1, 2019 to January 31, 2021. The participants were divided into two groups: COVID-19 group (March 1, 2020 - January 31, 2021) and reference group (March 1, 2019 - January 31, 2020). The incidence rate (IR) and relative risk (RR) of operations over different time frames were analyzed. Results A total 1351 participants met the inclusion criteria. 590 were operated during the COVID-19 period and 761 during the reference period. The IR of elective operations was decreased during the COVID-19 pandemic; 146 operations/100.000 population vs 192 operations/100.000 population during the reference period. RR was 0,76 (95% CI 0.6813-0.8545, p < 0.0001). Moreover, IR of emergency operations decreased insignificantly during the COVID-19 pandemic; 17,5 operations/100.000 population vs 19,4 operations/100.000 population during the reference period. RR was 0,9 (95% CI 0.6404- 1.2649, p 0.5441). No significant variations in the emergency operations have identified when different time frames were compared. Conclusions There is no evidence to support that COVID-19 pandemic has increased emergency hernia operations during the studied period despite the significant reduction of elective operations.
Cancer treatment is increasingly tailored to the individual patient. Treatment decisions are based on the evaluation of clinical stage which in turn is based on the result of the diagnostic pre-treatment work-up. The aim of this study was to investigate the accuracy of clinical staging of esophageal and gastric cancer in Sweden and what factors influence the quality of the staging procedure. Methods All patients operated for esophageal or gastric cancer, without neoadjuvant treatment, in Sweden from 2006 to 2018 was extracted from the Swedish national registry for esophageal and gastric cancer. Clinical TNM (cTNM) and pathological TNM (pTNM) was compared. The most common preoperative modalities for staging were endoscopy and CT-scan. Data on sex, age, smoking habits, multidisciplinary cancer conferences (yes/no), time of surgery (categorized in 5-year periods), number of resected lymph nodes and region of surgery were extracted from the registry. Uni- and multivariate logistic regression analyses were made comparing patients with correct cTNM to patients with incorrect cTNM. Results A total of 2500 patients met the inclusion criteria. 1173 patients were excluded because of missing data leaving 1327 patients for analyses. cTNM stage and pTNM stage was identical in 38% of patients. In 35% of patients there was a +/−1 stage difference comparing cTNM to pTNM. For esophageal cancer T-stage was on target in 32% and N-stage in 50% of cases. For gastric cancer the corresponding figures were 35% and 48% respectively. Multivariate regression analyzes showed that operation in the later time periods, a higher number of resected lymph nodes and discussion at multidisciplinary cancer conference improved staging accuracy. Conclusion In this study we found that 73% of patients were staged on target or +/− one stage-level. Operation in the later time periods, a higher number of resected lymph nodes and discussion at multidisciplinary cancer conference improved staging accuracy. This data indicate that treatment decisions should be made in a multidisciplinary setting. We believe that the gradual centralization of surgery and treatment decisions in Sweden during this time-period partly explains the improved accuracy over time.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.