Barajas-Gamboa Juan S, Khan Mohammed Sakib Ihsan, Romero-Velez Gustavo, Dang Jerry T, Diaz Del Gobbo Gabriel, Abdallah Mohammed, Pantoja Juan Pablo, Raza Javed, Abril Carlos, Guerron Alfredo D, Lee-St John Terrence, Corcelles Ricard, Kroh Matthew, Rodriguez John H
Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.
J Laparoendosc Adv Surg Tech A. 2024 Dec;34(12):1107-1110. doi: 10.1089/lap.2024.0241. Epub 2024 Sep 13.
The COVID-19 pandemic and subsequent lockdowns led to substantial changes in health-related behaviors and deferred elective surgeries. This study aimed to evaluate the impact of the COVID-19 lockdown on weight loss trajectories (WLT) and perioperative outcomes in primary bariatric surgery at a single tertiary referral center. Patients who underwent primary bariatric surgery immediately prior to the enforced lockdown (During-Lockdown Group, DLG) were compared with historical controls who underwent surgery before the lockdown (Before-Lockdown Group, BLG). WLT were estimated using a random intercept mixed-effects model with repeated measures. Cross-sectional group differences at 3- and 6-months post-surgery were examined. Perioperative outcomes were also analyzed. A total of 273 patients were included (133 BLG, 140 DLG). The adjusted average weight decreased in both groups over time at different levels. The expected difference in weight between BLG and DLG at 3-months was 1.06 kg ( = .013) and at 6-months was .04 kg ( = .920), respectively. There were no statistically significant differences in postoperative complications, emergency department visits, re-admission rates, re-operation rates, or mortality. This study suggests that bariatric procedures performed before the COVID-19 lockdown were effective and safe. Despite a statistically significant difference in weight between groups at 3- and 6-months post-surgery, the difference was small and unlikely to be clinically significant. Short-term outcomes were comparable between the two groups. Further investigation is warranted to assess the impact of lifestyle changes during the lockdown on long-term bariatric surgery outcomes.
新冠疫情及随后的封锁措施导致与健康相关的行为发生了重大变化,并推迟了择期手术。本研究旨在评估新冠疫情封锁对单一三级转诊中心原发性减肥手术的体重减轻轨迹(WLT)和围手术期结果的影响。将在强制封锁前立即接受原发性减肥手术的患者(封锁期间组,DLG)与在封锁前接受手术的历史对照组(封锁前组,BLG)进行比较。使用具有重复测量的随机截距混合效应模型估计WLT。检查术后3个月和6个月时的横断面组间差异。还分析了围手术期结果。总共纳入了273例患者(133例BLG,140例DLG)。随着时间的推移,两组的调整后平均体重均在不同水平下降。BLG和DLG在术后3个月时的预期体重差异为1.06千克(P = 0.013),在6个月时为0.04千克(P = 0.920)。术后并发症、急诊科就诊、再入院率、再次手术率或死亡率方面均无统计学显著差异。本研究表明,在新冠疫情封锁前进行的减肥手术是有效且安全的。尽管术后3个月和6个月时两组之间的体重存在统计学显著差异,但差异很小,不太可能具有临床意义。两组的短期结果具有可比性。有必要进一步调查以评估封锁期间生活方式改变对减肥手术长期结果的影响。