Master in Research in Health Sciences, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Region Metropolitana, Chile.
Obes Surg. 2023 Nov;33(11):3431-3436. doi: 10.1007/s11695-023-06677-1. Epub 2023 Sep 6.
At the beginning of the pandemic, studies showed a higher risk of severe surgical complications and mortality among patients with perioperative SARS-CoV-2 infection, which led to the suspension of elective surgery. Confinement and lockdown measures were shown to be associated with weight gain and less access to medical and surgical care in patients with obesity, with negative health consequences. To evaluate the safety of bariatric surgery during the pandemic, we compared 30-day complications between patients who underwent bariatric surgery immediately before with those who underwent bariatric surgery during the opening phase of the pandemic.
Observational analytical study of a non-concurrent cohort of patients who underwent bariatric surgery in 2 periods: pre-pandemic March 1 to December 31, 2019, and pandemic March 1 to December 31, 2020. Surgical complications were defined using the Clavien-Dindo classification.
Pre-pandemic and pandemic groups included 256 and 202 patients who underwent primary bariatric surgery, respectively. The mean age was 37.6 + 10.3 years. The overall complication rate during the first 30 days of discharge was 7.42%. No differences between groups were observed in severe complications (pre-pandemic 1.56% vs. pandemic 1.98%, p: 0.58). No mortality was reported. Overall 30-day readmission was 3.28% with no differences between groups.
The findings of this study did not find a difference in the rate of severe complications, nor also we report severe COVID-19 complications in this high-risk population. During the pandemic, with appropriately implemented protocol, the resumption of bariatric surgery is possible with no increased risk for patients.
在大流行开始时，研究表明围手术期 SARS-CoV-2 感染的患者发生严重手术并发症和死亡率的风险更高，这导致了择期手术的暂停。限制和封锁措施与肥胖患者体重增加和获得医疗和手术护理机会减少有关，对健康造成负面影响。为了评估大流行期间减肥手术的安全性，我们比较了在大流行开放阶段之前接受减肥手术的患者与在该阶段接受减肥手术的患者的 30 天并发症。
对在两个时期接受减肥手术的非同期队列患者进行观察性分析研究：大流行前 2019 年 3 月 1 日至 12 月 31 日，大流行期间 2020 年 3 月 1 日至 12 月 31 日。使用 Clavien-Dindo 分类法定义手术并发症。
大流行前和大流行期间的组分别包括 256 名和 202 名接受原发性减肥手术的患者。平均年龄为 37.6±10.3 岁。出院后 30 天内的总体并发症发生率为 7.42%。两组严重并发症无差异（大流行前 1.56%对大流行后 1.98%，p：0.58）。未报告死亡。总体 30 天再入院率为 3.28%，两组间无差异。
本研究结果未发现严重并发症发生率存在差异，也未报告该高风险人群中 COVID-19 严重并发症。在大流行期间，通过适当实施协议，恢复减肥手术是可能的，患者风险不会增加。
