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腹腔镜手术和开放手术中手术烟雾中的新冠病毒传播:一项系统综述

COVID-19 transmission in surgical smoke during laparoscopy and open surgery: a systematic review.

作者信息

Matta Imad, Laganà Antonio Simone, Ghabi Elie, Bitar Lynn, Ayed Amal, Petousis Stamatios, Vitale Salvatore Giovanni, Sleiman Zaki

机构信息

Division of Urology, University of Balamand, Beirut, Lebanon.

Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.

出版信息

Minim Invasive Ther Allied Technol. 2022 Jun;31(5):690-697. doi: 10.1080/13645706.2021.1982728. Epub 2021 Oct 6.

Abstract

AIM

To evaluate the risk of SARS-CoV-2 transmission in surgical smoke and aerosols during laparoscopy and open surgery.

MATERIAL AND METHODS

A systematic review (PROSPERO ID: CRD42021268366) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were selected based on the title and abstract as well as the type of publication. Primary objectives of the study were to assess potential risk of contamination as well as comparing laparoscopic and open procedures in terms of danger of SARS-COV-2 transmission.

RESULTS

Fifty-three articles were identified and included in the review. No case of SARS-CoV-2 transmission to operating room personnel during open or minimally invasive surgery was identified at the time the review was conducted. Furthermore, no significant difference was observed between smoke and aerosols generated from open surgery and those generated from minimally invasive surgery.

CONCLUSION

COVID-19 transmission in surgical smoke and aerosols has yet to be observed. However, given the potential risk of viral transmission, caution should be exercised when performing surgery to ensure the safety of the operating room personnel. When clinically indicated and when protective measures can be implemented, minimally invasive surgery should be performed instead of open surgery to ensure optimal patient outcomes.

摘要

目的

评估腹腔镜手术和开放手术过程中手术烟雾和气溶胶导致严重急性呼吸综合征冠状病毒2(SARS-CoV-2)传播的风险。

材料与方法

根据系统评价与Meta分析的首选报告项目指南进行系统评价(国际前瞻性系统评价注册库编号:CRD42021268366)。根据标题、摘要以及出版物类型选择文章。该研究的主要目的是评估污染的潜在风险,并比较腹腔镜手术和开放手术在SARS-CoV-2传播风险方面的差异。

结果

共识别出53篇文章并纳入该评价。在进行该评价时,未发现开放手术或微创手术期间有SARS-CoV-2传播给手术室人员的病例。此外,开放手术产生的烟雾和气溶胶与微创手术产生的烟雾和气溶胶之间未观察到显著差异。

结论

尚未观察到手术烟雾和气溶胶中有新型冠状病毒肺炎(COVID-19)传播。然而,鉴于病毒传播的潜在风险,进行手术时应谨慎操作,以确保手术室人员的安全。在有临床指征且能够实施防护措施时,应进行微创手术而非开放手术,以确保患者获得最佳预后。

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