Implications of COVID-19 pandemic on laparoscopic and abdominal surgery for benign adnexal conditions: Single center experience

Abstract

Introduction/Aim: COVID-19 pandemic posed a challenge in patient treatment and caused problems in the organization of health systems in many countries. The study aimed to analyze and quantify the influence of COVID-19 pandemic on performing surgeries for benign adnexal conditions with classic (open abdominal) and minimally invasive (laparoscopic) approach at the Clinic for Gynecology and Obstetrics University Clinical Center of Serbia. Material and Methods: The study retrospectively analyzed all patients who were operated due to benign adnexal masses at our Clinic during the past five years. We compared numbers and types of operations before and during the pandemic. Results: The study included 2166 patients who significantly more often had laparoscopic (61.9%) than open surgeries (38.1%). Surgeries of benign adnexal masses were elective in 53.2% cases, whereas in 46.8% cases those were emergency surgeries. Before the pandemic laparoscopic surgeries (mostly cystectomies) were on the rise. A reduction in laparoscopic and open surgeries was seen in the year 2020 (p=0.001). Moreover, the majority of surgeries were emergency surgeries (76.2%; p=0.001). Nevertheless, this decrease was significant only for laparoscopic cystectomies (p=0.001), but not for adnexectomies (p=0.224) and salpingectomies (p=0.762). Likewise, the 2020 reduction in open cystectomies (p=0.073), adnexectomies (p=0.836) and salpingectomies (p=0.241) was not significant either. During 2021, the number of surgical procedures for benign adnexal masses started to rise again (p=0.023). No intra-hospital COVID-19 infections were registered. Conclusion: The total number of operations of benign adnexal masses in our Clinic decreased and was limited to emergencies, which was mostly reflected in minimally invasive surgery.