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Review
. 2023 Aug;174(2):196-202.
doi: 10.1016/j.surg.2023.03.008. Epub 2023 Apr 11.

Impact of COVID-19 lockdowns on postoperative morbidity after hepatectomy: A propensity-score matching study on a national French database

Alexandra Nassar  1 , Stylianos Tzedakis  2 , Ugo Marchese  2 , Alix Dhote  2 , Mohamed Sabri Dallel  3 , Gaanan Naveendran  2 , Martin Gaillard  2 , Romain Coriat  4 , Jeanne Reboul Marty  5 , Basile Fuchs  5 , David Fuks  2
Affiliations
Review

Impact of COVID-19 lockdowns on postoperative morbidity after hepatectomy: A propensity-score matching study on a national French database

Alexandra Nassar et al. Surgery. 2023 Aug.

Abstract

Background: The impact of the SARS-CoV-2 pandemic on managing liver malignancies worldwide is unknown. This study aimed to determine the impact of lockdowns on patient clinical pathways and postoperative morbi-mortality.

Methods: This study evaluated all adults' hospital stays for liver tumors between 2019 and 2021 from the national French discharge database. The primary outcome was the clinical pathway, especially surgical care and postoperative outcomes, between patients admitted during COVID-19 lockdown periods (lockdown group) and during the same periods of 2019 and 2021 (control groups).

Results: The overall population included 58,508 patients: 18,907 patients in the lockdown group, 20,045 in the 2019 control group, and 19,556 in the 2021 control group. Surgical activity decreased by 11.6% during lockdowns, with 1,514 (8.0%) of patients in the lockdown group treated by surgery, 1,514 (8.6%) in the 2019 control group (P < .001), and 1,466 (7.4%) in the 2021 control group. Chemotherapy was considered more during the lockdowns (P < .001). More patients were operated in small-volume centers during the lockdowns (34% vs 32% vs 32%, P = .034), and fewer were hospitalized in highly populated regions (P < .001). Postoperative morbidity (47% vs 47% vs 47%, P = .90) and mortality (3.3% vs 3.6% vs 3.1%, P = .80) were comparable in the 3 periods, with no influence of lockdowns on morbidity (risk ratio = 0.94, 95% confidence interval = 0.81-1.09, P = .40) or mortality (odds ratio = 1.12, 95% confidence interval = 0.72-1.74, P = .6). Postoperative pulmonary (17% vs 13%, P = .024) and septic complications (20% vs 15%, P = .022) were significantly higher during the first lockdown compared to the second.

Conclusion: This study provides a French overview of liver malignancy management during the COVID-19 pandemic. Moreover, surgical activity decreased by 11.6% in high-volume centers, with no impact on postoperative morbidity and mortality.

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Figures

Figure 1
Figure 1
Evolution of patients treated for liver tumours during 2019-2021. Hospitalisations for liver tumors on the left; Liver tumor’s resections on the right
Figure 2
Figure 2
Map of patients’ hospitalisations in France for liver tumors. Lockdown group on the left; 2019 Control group on the right
See this image and copyright information in PMC

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References

    1. Dowd J.B., Andriano L., Brazel D.M., Rotondi V., Block P., Ding X., et al. Demographic science aids in understanding the spread and fatality rates of COVID-19. Proc Natl Acad Sci U S A. 5 mai. 2020;117(18):9696–9698. - PMC - PubMed
    1. Gaudart J, Landier J, Huiart L, Legendre E, Lehot L, Bendiane MK, et al. Factors associated with the spatial heterogeneity of the first wave of COVID-19 in France: a nationwide geo-epidemiological study. Lancet Public Health. avr 2021;6(4):e222-31. - PMC - PubMed
    1. Tuech J.J., Gangloff A., Di Fiore F., Michel P., Brigand C., Slim K., et al. Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic. J Visc Surg. juin. 2020;157(3S1):S7-12. - PMC - PubMed
    1. Doglietto F., Vezzoli M., Gheza F., Lussardi G.L., Domenicucci M., Vecchiarelli L., et al. Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 1 août. 2020;155(8):691–702. - PMC - PubMed
    1. COVIDSurg Collaborative Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 4 juill. 2020;396(10243):27–38. - PMC - PubMed