Stelzner Sigmar, Keller Gudula, Gockel Ines, Herrmann Martin
Klinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
Praxis für Orthopädie, Dresden, Deutschland.
Chirurgie (Heidelb). 2023 Mar;94(3):191-198. doi: 10.1007/s00104-022-01795-5. Epub 2023 Jan 23.
The impacts of the climate crisis will result in a health crisis in addition to loss of habitats and increasing supply uncertainty. In this context, the health sector and especially surgery are relevant emitters of greenhouse gases, thus contributing to the magnitude of the climate crisis. Many reviews regarding the impacts on human health are available; however, a view from the surgical perspective has so far been underrepresented.
This narrative review summarizes the relevance of climate-related changes for the surgical disciplines based on a literature search.
Immediate impacts are expected by the increasing number of extreme weather events, e.g., floods, droughts and wildfires. In these settings, surgery is a part of the disaster medicine chain but simultaneously the functionality of surgical departments can be impaired or even break down when they are themselves affected by extreme weather events. Heat waves cause an increase in surgical site infections, which may lead to postponement of elective surgery for patients at high risk. Collateral impacts are mirrored by an increase in the incidence of lung and skin cancers, which often need surgical treatment within a multidisciplinary setting. Additionally, there are indirect impacts that are of a very different nature, e.g., inadequate diet which leads to further deterioration of the greenhouse gas footprint of the health sector due to the necessity of bariatric surgical capacities.
The climate crisis represents a major challenge in surgery and all other medical disciplines. At the same time is it indispensable that the health sector and therefore surgery, take steps towards a zero emission pathway.
气候危机的影响除了导致栖息地丧失和供应不确定性增加外，还将引发健康危机。在此背景下，卫生部门尤其是外科手术是温室气体的重要排放源，从而加剧了气候危机的程度。目前已有许多关于气候危机对人类健康影响的综述；然而，从外科手术角度的观点迄今仍未得到充分体现。
本叙述性综述基于文献检索总结了气候相关变化对外科各学科的相关性。
预计极端天气事件（如洪水、干旱和野火）数量的增加将产生直接影响。在这些情况下，外科手术是灾难医学链条的一部分，但当外科科室自身受到极端天气事件影响时，其功能可能会受损甚至瘫痪。热浪会导致手术部位感染增加，这可能导致高风险患者的择期手术推迟。肺癌和皮肤癌发病率的上升反映了附带影响，这些癌症在多学科治疗中往往需要手术治疗。此外，还存在性质截然不同的间接影响，例如饮食不足，由于肥胖手术能力的必要性，这会导致卫生部门的温室气体排放足迹进一步恶化。
气候危机是外科手术及所有其他医学学科面临的重大挑战。与此同时，卫生部门进而外科手术采取迈向零排放道路的措施不可或缺。
