Silva Leonardo Emilio DA, Cohen Ricardo Vitor, DE-Andrade James Camara, SzegÖ Thomas, Santo Marco AurÉlio, Ramos Almino Cardoso, Vilas-Boas Marcos LeÃo, Moraes-ZenÓbio Cristiane Moulin, Alencar-Meneguesso Annelise Mota, VON-Bahten Luiz Carlos
- Bariatric and Metabolic Surgery Board of The Brazilian College of Surgeons - Rio de Janeiro - RJ - Brazil.
- Federal University of Goias, Medical School - Department of Surgery - Goiania - GO - Brazil.
Rev Col Bras Cir. 2020 Jun 12;47:e20202640. doi: 10.1590/0100-6991e-20202640. eCollection 2020.
Prioritizing surgical procedures aims at facilitating patient's access according to the clinical needs, maximizing access equity, and minimizing the damage from delayed access. Previous categorization of elective bariatric surgery have been adapted to define an objective prioritizing system that reflects those principles for bariatric and metabolic operations. Given the factors that contribute to the morbidity and mortality of obese and type 2 diabetes patients, surgical prioritization should be based on clinical risk stratification. For patients with type 2 diabetes, we suggest that the operation may be prioritized for those with a higher risk of morbidity and mortality in a relatively short term. Likewise, it is necessary to guide the surgical team regarding the necessary care both in the pre, per and postoperative periods of bariatric and metabolic surgery. These recommendations aim to reduce the risk of in-hospital contamination of the surgical team among health professionals and between health professionals and patients. In summary, these recommendations have been shaped after a thorough analysis of the available literature and are extremely important to mitigate the harm related to the clinical complications of obesity and its comorbidities while keeping healthcare providers' and patients' safety.
对手术程序进行优先级排序旨在根据临床需求方便患者就诊，最大限度地提高就诊公平性，并将延迟就诊造成的损害降至最低。先前对择期减肥手术的分类已被采用，以定义一个客观的优先级排序系统，该系统反映了减肥和代谢手术的这些原则。鉴于导致肥胖和2型糖尿病患者发病和死亡的因素，手术优先级应基于临床风险分层。对于2型糖尿病患者，我们建议对于那些在相对短期内发病和死亡风险较高的患者，手术可优先进行。同样，有必要就减肥和代谢手术的术前、术中及术后所需护理向手术团队提供指导。这些建议旨在降低手术团队在医护人员之间以及医护人员与患者之间发生院内感染的风险。总之，这些建议是在对现有文献进行全面分析后形成的，对于减轻与肥胖及其合并症的临床并发症相关的危害，同时保障医护人员和患者的安全极为重要。
