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Takemura Y, Endo H, Hibi T, Nakano Y, Seishima R, Takeuchi M, Yamamoto H, Maeda H, Hanazaki K, Taketomi A, Kakeji Y, Seto Y, Ueno H, Mori M, Kitagawa Y. Impact of the COVID-19 pandemic on short-term outcomes after pancreaticoduodenectomy for pancreatic cancer: A retrospective study from the Japanese National Clinical Database, 2018-2021. Ann Gastroenterol Surg 2024; 8:877-887. [PMID: 39229557 PMCID: PMC11368487 DOI: 10.1002/ags3.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/23/2024] [Accepted: 03/09/2024] [Indexed: 09/05/2024] Open
Abstract
Aim The coronavirus disease 2019 (COVID-19) pandemic greatly impacted medical resources such as cancer screening, diagnosis, and treatment given to people for various diseases. We surveyed the impacts of the pandemic on the incidence of complications and mortality following pancreaticoduodenectomy for pancreatic cancer in Japan. Methods Data on patients who underwent pancreaticoduodenectomy for pancreatic cancer were extracted from the Japanese National Clinical Database (NCD) between 2018 and 2021. The number of the pancreaticoduodenectomy for pancreatic cancer were obtained and then the morbidity and mortality rates were evaluated using a standardized morbidity/mortality ratio (SMR), which is the ratio of the observed number of incidences to the expected number of incidences calculated by the risk calculator previously developed by the NCD. Results This study included 22 255 cases. The number of pancreaticoduodenectomies exhibited an increasing trend even during the COVID-19 pandemic. The mean observed incidence rates of Grade C pancreatic fistula and Clavien-Dindo grade ≥4 complications, and the 30-day mortality and surgical mortality rates were 0.8%, 1.8%, 0.8% and 0.9%, respectively. The standardized morbidity ratios did not increase during the COVID-19 pandemic. The standardized mortality ratios remained within the range of variations observed before the COVID-19 pandemic. Conclusion The increasing trend in the number of pancreaticoduodenectomies and favorable short-term outcomes even in the COVID-19 pandemic suggest the medical care for pancreatic cancer in Japan functioned well during the pandemic.
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Affiliation(s)
- Yusuke Takemura
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Hideki Endo
- Department of Healthcare Quality Assessment, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Taizo Hibi
- Department of Pediatric Surgery and TransplantationKumamoto University Graduate School of Medical SciencesKumamotoJapan
| | - Yutaka Nakano
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Ryo Seishima
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Masashi Takeuchi
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, Graduate School of MedicineThe University of TokyoTokyoJapan
| | | | | | - Akinobu Taketomi
- Department of Gastroenterological Surgery IHokkaido University HospitalHokkaidoJapan
| | - Yoshihiro Kakeji
- Database Committee, The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Hideki Ueno
- Database Committee, The Japanese Society of Gastroenterological SurgeryTokyoJapan
- Department of SurgeryNational Defense Medical CollegeSaitamaJapan
| | | | - Yuko Kitagawa
- Department of SurgeryKeio University School of MedicineTokyoJapan
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
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Hibi T, Yamamoto H, Miyoshi T, Ikeda N, Taketomi A, Ono M, Toi M, Hara H, Nagano H, Kitagawa Y, Mori M. Impact of the coronavirus disease 2019 pandemic on 20 representative surgical procedures in Japan based on the National Clinical Database: annual surveillance of 2021 by the Japan Surgical Society. Surg Today 2024; 54:751-762. [PMID: 38133829 DOI: 10.1007/s00595-023-02786-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE The volume of surgical services has significantly reduced globally due to the coronavirus disease 2019 (COVID-19) pandemic. This study evaluated the level of recovery in terms of the number of operations performed in Japan in 2021, based on nationwide periodic surveillance. METHODS Information on the weekly and annual volumes of 20 representative procedures in 6 surgical subspecialties in 2021 was extracted from the National Clinical Database. Statistical data for 2018 and 2019 (pre-pandemic era) were compared with those for 2020. Data on waves of infection, peak period, and high-prevalence areas (13 of 47 prefectures) were analyzed individually. RESULTS The volumes of the 10 procedures, including gastrectomy, hepatectomy, valve replacement and valve plasty, coronary artery bypass grafting, infrarenal abdominal aorta replacement, ventricular septal defect closure, lung lobectomy, inguinal hernia repair (age < 16 years old), and appendectomy (age < 16 years old), did not reach 95% of that in the pre-pandemic era. The most striking decline in the surgical volume of these 10 procedures was observed during the peak period of wave 5 in high-prevalence areas. CONCLUSION This near-complete enumeration survey identified the polarization of 20 representative procedures in terms of resumption of surgical service after the pandemic.
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Affiliation(s)
- Taizo Hibi
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan.
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Miyoshi
- Department of Healthcare Quality Assessment, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Norihiko Ikeda
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- The Japan Surgical Society, Tokyo, Japan
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akinobu Taketomi
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Kita-ku, Kita 15, Nishi 7, Sapporo, Hokkaido, 060-8638, Japan
| | - Minoru Ono
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masakazu Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Hisato Hara
- Department of Breast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroaki Nagano
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- Department of Gastroenterological, Breast, and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Yuko Kitagawa
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaki Mori
- Committee for Novel Coronavirus Disease 2019 Outbreak of the Japan Surgical Society, World Trade Center Building South Tower 11F, 2-4-1 Hamamatsu-cho, Minato-ku, Tokyo, 105-5111, Japan
- Tokai University, School of Medicine, 143, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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