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新冠肺炎疫情期间与疫情前减重手术的安全性和疗效比较分析:来自德黑兰肥胖治疗研究的见解。

A Comparative Analysis of Safety and Efficacy of Bariatric Surgery During the COVID-19 Pandemic and Pre-Pandemic Period: Insights from the Tehran Obesity Treatment Study.

机构信息

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

World J Surg. 2023 Dec;47(12):2949-2957. doi: 10.1007/s00268-023-07214-y. Epub 2023 Oct 14.

DOI:10.1007/s00268-023-07214-y
PMID:37838633
Abstract

BACKGROUND

The COVID-19 pandemic has raised global health concerns and posed challenges for postoperative follow-up care for patients undergoing bariatric surgery due to social distancing rules.

METHODS

This was a cohort study on patients with morbid obesity who underwent bariatric surgery and had been enrolled in Tehran Obesity Treatment Study. Patients who had surgery between March 2020 and March 2021 were classified as those undergoing the procedure amid the COVID-19 pandemic, while those who had surgery between March 2017 and March 2018 were categorized as the pre-pandemic group.

RESULTS

The study included 982 patients in the pre-COVID-19 pandemic group and 602 patients in the COVID-19 pandemic group, with mean ages of 39.61 and 39.51 years, respectively. After adjusting for preoperative body mass index (BMI) and surgery type, the patients who underwent surgery during the COVID-19 pandemic demonstrated comparable results to the pre-COVID-19 group in terms of total weight loss %, excess weight loss %, BMI reduction, and fat mass reduction during the 12-month postoperative period. Additionally, the rate of complications with a grade≥III based on the Clavien-Dindo classification was significantly lower in patients who underwent surgery during the COVID-19 pandemic. Notably, there were no deaths reported in either group.

CONCLUSION

Despite social isolation and unfavorable lifestyle modifications, bariatric surgery-induced weight loss after one year was the same in patients undergoing the procedure either before or after the implementation of social distancing measures. More research is needed to analyze the influence of the COVID-19 pandemic on the long-term outcomes of bariatric surgery.

摘要

背景

COVID-19 大流行引起了全球健康关注,并由于社交距离规则对接受减重手术的患者的术后随访护理带来了挑战。

方法

这是一项针对接受减重手术并已参加德黑兰肥胖治疗研究的病态肥胖患者的队列研究。2020 年 3 月至 2021 年 3 月期间接受手术的患者被归类为 COVID-19 大流行期间接受手术的患者,而 2017 年 3 月至 2018 年 3 月期间接受手术的患者被归类为大流行前组。

结果

研究包括大流行前组的 982 例患者和大流行期间组的 602 例患者,平均年龄分别为 39.61 岁和 39.51 岁。调整术前体重指数(BMI)和手术类型后,在 COVID-19 大流行期间接受手术的患者在术后 12 个月期间的总体重减轻率、超重体重减轻率、BMI 降低率和脂肪量减少率方面与大流行前组相当。此外,根据 Clavien-Dindo 分类,COVID-19 大流行期间接受手术的患者的≥III 级并发症发生率显著降低。值得注意的是,两组均无死亡报告。

结论

尽管存在社会隔离和不利的生活方式改变,但在实施社会隔离措施前后接受手术的患者在一年后进行减重手术引起的体重减轻是相同的。需要进一步研究以分析 COVID-19 大流行对减重手术长期结果的影响。

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Bariatr Surg Pract Patient Care. 2022 Jun 1;17(2):115-120. doi: 10.1089/bari.2021.0039. Epub 2022 Jun 8.
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Despite regression of healthy lifestyle habits, weight loss after bariatric surgery is not affected during the COVID-19 pandemic.尽管健康生活习惯有所倒退,但在 COVID-19 大流行期间,减重手术后的体重并未受到影响。
Surg Endosc. 2023 Jan;37(1):607-612. doi: 10.1007/s00464-022-09356-x. Epub 2022 Jun 13.
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Impact of the COVID-19 Pandemic on Metabolic and Bariatric Surgery Utilization and Safety in the United States.
COVID-19 大流行对美国代谢和减重手术利用和安全性的影响。
Obes Surg. 2022 Jul;32(7):2289-2298. doi: 10.1007/s11695-022-06077-x. Epub 2022 May 2.
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Effect of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834,647 patients.新冠疫情对北美减肥手术的影响:对 834647 名患者的回顾性分析。
Surg Obes Relat Dis. 2022 Jun;18(6):803-811. doi: 10.1016/j.soard.2022.03.012. Epub 2022 Mar 19.
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