Upper GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK.
Department of General Surgery, Leighton Hospital, Crewe, UK.
Curr Obes Rep. 2022 Sep;11(3):203-214. doi: 10.1007/s13679-021-00458-6. Epub 2021 Oct 28.
Coronavirus Disease-2019 (COVID-19) has had an enormous impact on all aspects of healthcare, but its effect on patients needing surgery and surgeons has been disproportionate. In this review, we aim to understand the impact of the pandemic on surgical patients and teams. We compiled the emerging data on pre-operative screening methods, vaccinations, safe-surgery pathways and surgical techniques and make recommendations for evidence-based safe-surgical pathways. We also present surgical outcomes for emergency, oncological and benign surgery in the context of the pandemic. Finally, we attempt to address the impact of the pandemic on patients, staff and surgical training and provide perspectives for the future.
Surgical teams have developed consensus guidelines and established research priorities and safety precautions for surgery during the COVID-19 pandemic. Evidence supports that surgery in patients with a peri-operative SARS-CoV-2 infection carries substantial risks, but risk mitigation strategies are effective at reducing harm to staff and patients. Surgery has increased risk for patients and staff, but this can be mitigated effectively, especially for elective surgery. Elective surgery can be safely performed during the COVID-19 pandemic employing the strategies discussed in this review.
2019 年冠状病毒病(COVID-19)对医疗保健的各个方面都产生了巨大影响,但对需要手术的患者和外科医生的影响不成比例。在这篇综述中,我们旨在了解大流行对手术患者和团队的影响。我们收集了有关术前筛查方法、疫苗接种、安全手术途径和手术技术的新数据,并针对基于证据的安全手术途径提出建议。我们还介绍了大流行背景下急诊、肿瘤和良性手术的手术结果。最后,我们试图解决大流行对患者、工作人员和外科培训的影响,并为未来提供观点。
外科团队已经为 COVID-19 大流行期间的手术制定了共识指南和研究重点以及安全预防措施。有证据表明,围手术期 SARS-CoV-2 感染患者的手术风险很大,但风险缓解策略可有效降低对工作人员和患者的伤害。手术会增加患者和工作人员的风险,但可以通过有效措施来减轻,尤其是对于择期手术。在 COVID-19 大流行期间,采用本综述中讨论的策略可以安全地进行择期手术。