The impact of surgical capacity shortages on disease-related morbidity in benign conditions: a comparative cohort study of gallstone and inguinal hernia care during the COVID-19 pandemic.

BACKGROUND

With increasing pressure on operating room capacity due to growing surgical demand and constraints in cost, workforce, and sustainability, real-world scenarios such as the COVID-19 pandemic offer valuable insights. This study assessed the pandemic's impact on surgical care for patients with gallstone disease or inguinal hernia, focusing on disease-related and surgical complications.

METHODS

This multicenter historical cohort study included patients treated in 2019 and 2020 at three Dutch hospitals. Data were collected from hospital systems and patient records. The COVID period (March-December 2020) was compared to a reference period (March-December 2019). The primary outcome of this study was the rate of disease-related complications. Secondary outcomes included surgery rates, hospital presentations and admissions, time to surgery, surgical complications, length of hospital stay, and readmissions.

RESULTS

In total, 1572 patients with gallstone disease and 1511 with inguinal hernia were included. During the COVID period, fewer cholecystectomies were performed (59.8% vs. 67.7%, p = 0.001), and complicated gallstone disease increased (28.5% vs. 21.6%, p = 0.002). No significant differences were found in the rate of inguinal hernia repairs (61.6% vs. 63.5%, p = 0.46) or hernia-related complications (5.4% vs. 3.7%, p = 0.139). Surgical complication rates were similar across both periods for both conditions.

CONCLUSIONS

Limited surgical availability during the COVID-19 period was linked to reduced cholecystectomy rates and more complicated gallstone disease, without affecting inguinal hernia outcomes or surgical complication rates.