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Vol. 44. Issue 10.
Pages 659-664 (December 2020)
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Vol. 44. Issue 10.
Pages 659-664 (December 2020)
Original article
Impact of the COVID-19 pandemic on the surgical activity of Pediatric Urology: analysis of postoperative complications according to the Clavien-Dindo classification
Repercusión de la pandemia COVID-19 sobre la actividad quirúrgica de Urología Pediátrica: análisis de las complicaciones posquirúrgicas según la clasificación de Clavien-Dindo
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L. Merino-Mateo
Corresponding author
lara.merino@salud.madrid.org

Corresponding author.
, C. Tordable Ojeda, D. Cabezalí Barbancho, A. Gómez Fraile
Servicio de Cirugía Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
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Tables (4)
Table 1. Summary of the recommendations from the EAU/ESPU Pediatric Urology Guidelines Panel applicable during the COVID-19 pandemic.
Table 2. Clavien-Dindo classification of surgical complications.
Table 3. Descriptive analysis of the sample in relation to each subgroup of the de-escalation phase. Data are described as absolute frequencies and percentage, respectively.
Table 4. Description of the complications recorded, treatment performed and grade, according to the Clavien-Dindo classification.
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Abstract
Introduction and objective

The "Coronavirus Disease 2019" (COVID-19) has caused a pandemic of global impact that forced social-political measures to be taken, such as the declaration of the state of alarm in Spain. At the same time, the reorganization of the pediatric medical-surgical activities and infrastructures was carried out, with the consequent suspension of the non-urgent surgical activity of Pediatric Urology. We analyzed the impact of the COVID-19 pandemic on surgical activity in a Pediatric Urology division, as well as surgical complications according to the Clavien-Dindo classification.

Materials and methods

A systematic review of epidemiological, clinical and surgical data was carried out, including complications and readmissions of all patients operated on in the division of Pediatric Urology within the duration of the state of alarm. Five time periods have been created according to the de-escalation phases.

Results

Forty-nine surgical procedures were carried out on 45 patients (8 prior to the implementation of the de-escalation phases). High priority pathologies were the most frequent in the first phases, being the ureteropelvic junction (UPJ) obstruction the most prevalent. Four complications were recorded (8.8%), none of them were respiratory.

Conclusions

The EAU recommendations for the resumption of surgical activity have allowed a correct, safe and gradual transition to the routine surgical activity in Pediatric Urology. The Clavien-Dindo classification is useful and valid for application in this division. No respiratory complications have been reported that could be attributable to the pandemic situation.

Keywords:
COVID-19
Surgical activity
Pediatric urology
Surgical complications
Resumen
Introducción y objetivo

El “Coronavirus Disease 2019” (COVID-19) ha ocasionado una pandemia de repercusión mundial que obligó a tomar medidas social-políticas como la declaración del estado de alarma en España. Paralelamente se llevo a cabo la restructuración de las actividades e infraestructuras medico-quirúrgicas pediátricas, con la consecuente suspensión de la actividad quirúrgica no urgente de Urología Pediátrica. Analizamos la repercusión de la pandemia COVID-19 sobre la actividad quirúrgica en una sección de Urología Pediátrica, así como las complicaciones quirúrgicas según la clasificación de Clavien- Dindo.

Materiales y métodos

Se procedió a la revisión sistemática de los datos epidemiológicos, clínicos y quirúrgicos, incluyendo las complicaciones y reingresos de todos los pacientes intervenidos en la sección de Urología Pediátrica desde la declaración del estado de alarma hasta el levantamiento del mismo. Para su estudio se procedió a la división en cinco bloques temporales acorde a las fases de desescalada.

Resultados

Se realizaron 49 intervenciones quirúrgicas en 45 pacientes (8 previos a la implantación de las fases de desescalada). La patología con prioridad alta fue la más frecuente en las primeras fases, siendo la estenosis de la unión pieloureteral (EPU) la más prevalente. Se registraron cuatro complicaciones (8,8%), ninguna de ellas de origen respiratorio.

Conclusiones

Las recomendaciones de la EAU para la reanudación de la actividad quirúrgica han permitido una correcta, segura y gradual transición al ritmo quirúrgico habitual en Urología Pediátrica. La clasificación de Clavien- Dindo es útil y válida para su aplicación en está sección. No se han registrados complicaciones respiratorias que pudiesen ser atribuibles a la situación pandémica.

Palabras clave:
COVID-19
Actividad quirúrgica
Urología pediátrica
Complicaciones quirúrgicas

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