Department of Surgery, North Island Hospital, Vancouver Island Health Authority, 375 2 Ave, Campbell River, BC, V9W 3V1, Canada.
Department of Surgery, University of British Columbia, 2775 Laurel Street, 11th Floor, Vancouver, BC, V5Z 1M9, Canada.
Surg Endosc. 2021 Jun;35(6):2428-2439. doi: 10.1007/s00464-020-08261-5. Epub 2021 Jan 25.
Concerns regarding the aerosolized transmission of SARS-CoV-2 via SS have caused significant apprehension among surgeons related to the use of minimally invasive surgery (MIS) during the COVID19 pandemic. While a limited number of studies have previously demonstrated the presence of viral material in SS, no comprehensive systematic review exists on the subject of viral transmission in SS. Methods A systematic review of the literature was conducted as per PRISMA guidelines. MEDLINE, EMBASE, and CENTRAL databases were searched for publications reporting the primary outcome of the presence of viral particles in SS and secondary outcomes of indices suggesting transmission of viable virus particles in SS producing clinically important infection. All human, animal, and in vitro studies which used accepted analytic techniques for viral detection were included. A meta-analysis was not complete due to methodologic heterogeneity and inconsistent reporting of outcomes of interest.
23 publications addressed the presence of viral components in SS, and 19 (83%) found the presence of viral particles in SS. 21 publications additionally studied the ability of SS to induce clinically relevant infection in host cells, with 9 (43%) demonstrating potential for viral transmission.
Evidence exists for viral transmission via SS. However, HPV remains the only virus with documented transmission to humans via SS. While meaningful translation into practical guidelines during the COVID pandemic remains challenging, no evidence exists to suggest increased risk in MIS.
由于担心 SARS-CoV-2 通过 SS 气溶胶传播，COVID19 大流行期间，外科医生对微创外科（MIS）的使用产生了极大的担忧。虽然之前已有少量研究表明 SS 中存在病毒物质，但目前尚无关于 SS 中病毒传播的综合系统评价。
按照 PRISMA 指南进行文献系统评价。检索 MEDLINE、EMBASE 和 CENTRAL 数据库，以寻找报告 SS 中存在病毒颗粒的主要结果以及 SS 中产生具有临床重要性感染的可行病毒颗粒传播指标的次要结果的出版物。纳入所有使用公认的病毒检测分析技术的人类、动物和体外研究。由于方法学异质性和报告结果不一致，Meta 分析无法完成。
23 篇文献探讨了 SS 中病毒成分的存在，其中 19 篇（83%）发现 SS 中存在病毒颗粒。21 篇文献进一步研究了 SS 诱导宿主细胞产生临床相关感染的能力，其中 9 篇（43%）证明了病毒传播的潜力。
有证据表明 SS 可传播病毒。然而，HPV 仍然是唯一一种通过 SS 传播给人类的病毒。虽然在 COVID 大流行期间将其转化为实用指南具有挑战性，但没有证据表明 MIS 风险增加。
