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COVID-19 诊断与袖状胃切除术和 Roux-en-Y 胃旁路术术后结局的关系:一项全国性队列研究。

Association between COVID-19 diagnosis and postoperative outcomes in sleeve gastrectomy and Roux-en-Y gastric bypass: A national cohort study.

机构信息

Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.

Department of Surgery, University of Utah, Salt Lake City, UT, USA.

出版信息

Am J Surg. 2024 Apr;230:43-46. doi: 10.1016/j.amjsurg.2023.11.036. Epub 2023 Nov 29.

DOI:10.1016/j.amjsurg.2023.11.036
PMID:38101978
Abstract

BACKGROUND

We seek to determine the association between COVID-19 diagnosis and postoperative outcomes following bariatric surgery.

METHODS

Using the Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) database, patients undergoing sleeve gastrectomy and gastric bypass without a COVID-19 diagnosis were 2:1 propensity-score matched to those with COVID-19 infection pre or postoperatively.

RESULTS

1369 (0.74 ​%) and 1331 (0.72 ​%) patients had a COVID-19 diagnosis within 14 days prior to or 30 days after their operation, respectively. Patients with preoperative COVID-19 infection had equivalent outcomes to COVID-19 negative patients (all p ​> ​0.05). Postoperative COVID-19 diagnosis was associated with worse outcomes including increased risk of anastomotic/staple line leak (1.1 ​% vs 0.1 ​%, p ​< ​0.001), postoperative pneumonia (2.9 ​% vs 0.1 ​%, p ​< ​0.001), and 30-day reoperation (2.1 ​% vs 0.9 ​%, p ​= ​0.002).

CONCLUSIONS

Postoperative diagnosis of COVID-19 after bariatric surgery is associated with worse outcomes; however, it is safe to perform these procedures on patients recently convalesced from COVID-19 infection.

摘要

背景

我们旨在确定 COVID-19 诊断与减重手术后结局之间的关联。

方法

利用代谢和减重手术认证质量改进项目(MBSAQIP)数据库,将术前或术后无 COVID-19 诊断的袖状胃切除术和胃旁路术患者按 2:1 比例与 COVID-19 感染患者进行倾向评分匹配。

结果

分别有 1369 例(0.74%)和 1331 例(0.72%)患者在手术前 14 天内或手术后 30 天内被诊断为 COVID-19。术前 COVID-19 感染患者的结局与 COVID-19 阴性患者相当(均 p>0.05)。术后 COVID-19 诊断与更差的结局相关,包括吻合口/吻合线漏的风险增加(1.1%比 0.1%,p<0.001)、术后肺炎(2.9%比 0.1%,p<0.001)和 30 天再次手术(2.1%比 0.9%,p=0.002)。

结论

减重手术后 COVID-19 的术后诊断与更差的结局相关;然而,对最近从 COVID-19 感染中康复的患者进行这些手术是安全的。

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