The effects of COVID-19 pandemic on pediatric neurosurgery practice and training in a developing country

Abstract

Purpose COVID-19 pandemic has influenced all aspects of societies, with the healthcare being the most affected field. All specialties including neurosurgery are involved, and due to resource limitations, the number of elective surgeries in subspecialized filed has substantially decreased. Herein, we report our practice experience in pediatric neurosurgery in a tertiary hospital during pandemic, and the effects of pandemic on educational issues. Methods All the patients on whom any kind of neurosurgical operation was performed from March to June 2020 were retrospectively collected, and also from the same period in the previous year. Results A total of 111 patients underwent surgery in this period. This figure was 159 patients during the same period in 2019. The total number of surgical cases reduced by 31% compared to the last year. While ventriculoperitoneal shunts and supratentorial tumor were more frequent, there was a considerable reduction in subspecialized educational surgeries like neural tube defects and craniosynostoses. Conclusion CVID-19 pandemic changed all scopes of medical practice and training. Considering the limitation in the available resources, the number of educational cases may decrease in subspecialized disciplines like pediatric neurosurgery. If pandemic continues, alternative measures should be taken to compensate for the shortcoming in technical and practical training.

The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

“…The majority of them described it ‘severe’ or ‘significant’ and some even ‘catastrophic’ [ 19 , 21 , 22 , 28 , 30 – 43 ]. These reports come both from developed [ 13 , 21 , 22 , 24 , 26 , 31 – 34 , 44 – 52 ] and developing countries [ 28 , 30 , 35 , 53 – 55 ] with very different healthcare systems. Moreover, the results were uniform between a variety of surgical specialties; general surgery [ 13 , 19 , 21 , 30 , 32 , 34 , 37 , 41 , 42 , 44 , 47 , 56 , 57 ], orthopaedics [ 19 , 24 , 58 ], ENT (ear, nose, throat) surgery [ 19 , 31 , 50 ], vascular surgery [ 19 , 22 , 26 ], urology [ 22 , 26 , 53 ], oral and maxillofacial surgery [ 19 , 33 ], and neurosurgery [ 19 , 54 , 59 ].…”

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

“…This reduction was shown to negatively impact neurosurgical trainees, especially regarding the reduced quantity and variety of cases available. This led to reduced procedural skills' subspecialisation, reduced responsibilities, poor independent management and hospital access [15,[19][20][21][22]. In some centres, these reductions in case load have been more apparent for residents, with one US teaching hospital observing a 59% decrease in bedside procedures for residents when compared with previous years [16].…”

“…Additionally, the virtual education adaptations implemented in training programmes were ineffective in teaching residents the manual dexterity demanded in the operating theatre, as well as the pre-and post-operative management of patients in a clinical setting [22,27].…”

Presidential address—the Black Swan: ISPN and pediatric neurosurgery in times of COVID-19

“…Pediatric patients and/or caregivers were usually unaware of the possibility of SARS-CoV-2 infection when arriving to ER and testing was not always possible before emergent surgery. Patients with scheduled non-emergent surgery and those undergoing aerosol-producing procedures such as intubation and endoscopic procedures in general require preoperative testing [19,34].…”