İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center, Fulya Mah. Yeşilçimen Sok. 12/407 34394, Şişli, İstanbul, Turkey.
Obes Surg. 2021 Jul;31(7):3026-3030. doi: 10.1007/s11695-021-05339-4. Epub 2021 Mar 11.
During the Covid-19 pandemic, the outcome of symptomatic Covid-19 infection occurring early after elective operations is reportedly associated with fatalities. Incidence is unknown and data on bariatric practice is scarce. Covid-19 exposure status and outcomes of sleeve gastrectomy (SG) between the first two peaks of the pandemic are prospectively evaluated.
During our "opening-phase," candidates for SG were enrolled after written informed consent was obtained which specifically emphasized the additional risks of the Covid-19. Viral exposure history and swab/RNA testing were obtained from all. Preoperative antibody testing was also performed, once became available. Preoperative workout, definitions, and surgical technique were standard. Patients were followed up with video-calls. All perioperative data is prospectively recorded.
Between June 23 and November 20, 87 consecutive SGs were performed without mortality and conversion with a 1.2% major early complication rate. Single complication was due to Covid-19, acutely becoming symptomatic one day following the SG. During the first year of the pandemic, a minimum of 13.8% of the patients had encountered the virus and the rate of developing postoperative symptomatic Covid-19 was 6.3% including a patient with full-blown Covid-19 pneumonia 1 day after SG. Results on weight loss matched expectations.
Currently, differing from the first peak of pandemic, vaccines are underway although a more serious surge continues. Given the high rate of morbidity and mortality of Covid-19 infection early after elective operations, caution is warranted when balancing the expected benefit from an elective procedure against the risk of acquiring perioperative Covid-19 infection.
据报道，在新冠疫情期间，择期手术后早期发生的有症状新冠感染的结果与死亡率有关。发病率尚不清楚，关于减肥手术的数据也很少。本研究前瞻性评估了疫情前两个高峰期之间袖状胃切除术（SG）的新冠暴露状况和结果。
在我们的“开放阶段”，在获得书面知情同意后，招募了接受 SG 的候选者，该同意特别强调了新冠的额外风险。从所有患者中获取病毒暴露史和拭子/RNA 检测结果。一旦可用，还进行了术前抗体检测。术前锻炼、定义和手术技术都是标准的。通过视频通话对患者进行随访。所有围手术期数据都是前瞻性记录的。
在 6 月 23 日至 11 月 20 日期间，连续进行了 87 例 SG，无死亡和转为其它术式，早期主要并发症发生率为 1.2%。单一并发症是由新冠引起的，在 SG 后一天突然出现症状。在疫情爆发的第一年，至少有 13.8%的患者接触过病毒，术后发生有症状新冠的发生率为 6.3%，其中一名患者在 SG 后 1 天出现了新冠肺炎肺炎的全面症状。减肥效果与预期相符。
目前，与疫情的第一个高峰期不同，疫苗正在进行中，尽管更严重的疫情仍在继续。鉴于择期手术后早期新冠感染的发病率和死亡率较高，在平衡择期手术的预期收益与围手术期新冠感染风险时应保持谨慎。
