School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Department of Internal Medicine, School of Medicine, Kenya Methodist University, Meru, Kenya.
Langenbecks Arch Surg. 2021 Jun;406(4):1007-1014. doi: 10.1007/s00423-021-02142-8. Epub 2021 Mar 6.
There are still concerns over the safety of laparoscopic surgery in coronavirus disease 2019 (COVID-19) patients due to the potential risk of viral transmission through surgical smoke/laparoscopic pneumoperitoneum.
We performed a systematic review of currently available literature to determine the presence of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in abdominal tissues or fluids and in surgical smoke.
A total of 19 studies (15 case reports and 4 case series) comprising 29 COVID-19 patients were included. The viral RNA was positively identified in 11 patients (37.9%). The samples that tested positive include the peritoneal fluid, bile, ascitic fluid, peritoneal dialysate, duodenal wall, and appendix. Similar samples, together with the omentum and abdominal subcutaneous fat, tested negative in the other patients. Only one study investigated SARS-COV-2 RNA in surgical smoke generated during laparoscopy, reporting negative findings.
There are conflicting results regarding the presence of SARS-COV-2 in abdominal tissues and fluids. No currently available evidence supports the hypothesis that SARS-COV-2 can be aerosolized and transmitted through surgical smoke. Larger studies are urgently needed to corroborate these findings.
由于通过手术烟雾/腹腔镜气腹传播病毒的潜在风险，新冠肺炎（COVID-19）患者行腹腔镜手术的安全性仍存在担忧。
我们对现有文献进行了系统回顾，以确定 SARS-CoV-2 是否存在于腹部组织或液体以及手术烟雾中。
共纳入 19 项研究（15 例病例报告和 4 例病例系列），共 29 例 COVID-19 患者。11 例患者（37.9%）的病毒 RNA 呈阳性。检测呈阳性的样本包括腹膜液、胆汁、腹水、腹膜透析液、十二指肠壁和阑尾。其他患者的类似样本以及大网膜和腹部皮下脂肪检测结果为阴性。仅有一项研究调查了腹腔镜手术过程中产生的手术烟雾中的 SARS-CoV-2 RNA，报告结果为阴性。
关于 SARS-CoV-2 是否存在于腹部组织和液体中，目前存在相互矛盾的结果。尚无现有证据支持 SARS-CoV-2 可通过手术烟雾气溶胶化并传播的假说。迫切需要更大规模的研究来证实这些发现。
