ABSTRACT
Background: Elective Bariatric and Metabolic Surgeries (BMS) were stopped all over the world during this COVID-19 pandemic to ensure the availability of hospital resources to combat the pandemic and also to protect its first responders and other care givers. Only emergency and urgent cases were permitted. However, the actions taken early in the pandemic by the government of Taiwan and our center's collective efforts allowed us to be the only center in the world to safely perform elective BMS unhampered. Method(s): A retrospective review and analysis of the trends, complications and safety for all elective BMS from January to April 2020 was done. We reviewed the preparations, healthcare policies, and protocols created by the government of Taiwan against COVID-19 and our center's robust algorithm for patient and healthcare workers (HCW) surveillance and safety. Results and Discussion: A total of 99 patients underwent elective BMS from January to April 2020. The breakdown was 59 females and 40 males with an average body mass index (BMI) of 35.20 kg/m2 and 40.68 kg/m2 respectively. Compared to the previous year when a total 117 patients had surgery, a decline of 18 elective operations (-15.38%) was noted. There were no reported cases of a patient developing postoperative COVID-19 or a HCW. Conclusion(s): Elective operations may not need to be postponed if you have already in place early mitigation measures to prevent a pandemic spread, including but not limited to a prompt implementation of protocols and strict adherence to these measures. (Figure Presented).
ABSTRACT
Background: COVID-19 pandemic has taken the world by surprise with the depth and breadth of its effect on all walks of life, bariatric surgery being no exception. With the scientific literature hitherto unable to comment and ascertain the influence of the COVID-19 pandemic on bariatric surgery and the level of harm experienced by bariatric surgeons, we- TUGS 'Level of Harm' collaborative group- attempted to gauge the effect of the said pandemic on bariatrics surgery specifically vis a vis the level of harm experienced by bariatric surgeons due to the pandemic. Method(s): A virtual questionnaire- developed on both: Google forms and Survey Monkey- was circulated via TUGS social media platforms to reach bariatric consultant surgeons, fellows and residents practising throughout the world in a bid to explore the influence of the COVID-19 pandemic on their surgical practice including but not limited to the annual surgical volume including re-do surgeries volume and postoperative complications. Moreover, they were also requested to categorise their respective level of harm vis a vis bariatric surgical interventions they undertake. After de-identification of the data, SPSS (V.26) was adopted to undergo statistical analysis. After exploring the dataset by descriptive analyses, the Chi-square test was applied to pursue the association of categorical variables with the reported level of harm. A double-sided p-value of less than 0.05 was considered statistically significant. Result(s): 16.8% of the respondents (21/125) indicated no harm vis a vis bariatrics surgery work whereas a comparative 18.4% of the respondents (23/125) reported moderate harm with significant worsening of symptoms. None of those who indicated less than 10% increase in surgery waitlisted patients being subjected to endoscopic interventions (0/14) reported Moderate Harm for bariatrics surgery work with significant worsening of symptoms whereas 1 in every 3 of those who indicated between 10% to 25% increase in surgery waitlisted patients being subjected to endoscopic interventions (5/15) reported such level of harm for bariatrics surgery work. (p < 0.001) Upon exhaustive sub-group analysis, it was uncovered that 33.6% of bariatrics surgical professionals perceived no harm (no evidence of change in clinical condition) during gastric band or related surgery work with only 4% perceiving Moderate Harm (significant worsening of symptoms/ comorbidities control/ minor increase in medications) for such surgical interventions. All of those who reported No harm for gastric band or related surgical work reported that Single anastomosis duodeno-ileal bypass (SADI-S) accounts for 10% of their practice whereas none of those who indicated that SADI-S accounts for more than 10% of their practice reported No harm for such surgical work. (p = 0.019) Conclusion(s): The global snapshot illustrates a trend of low harm vis a vis bariatrics surgery work in surgical professionals practising in the private sector with a lesser number of patients developing COVID-19 postoperatively and no postoperative COVID-19 related mortality. The patient being subjected to endoscopic intervention portends a higher level of harm for bariatrics surgical work- strict adherence to criteria and safety protocols being a logical inference. For gastric band and related surgery work, preoperative COVID-19 testing appears to be influenced by confounders in its effect on the surgeon's level of harm for the said interventions warranting further exploration. SADI-S, at a cut-off of 10%, exhibits strong interaction with the surgeon's level of harm for gastric band insertion and relation surgery work. Women surgical professionals came out to exhibit equivalent mental resilience and technical prowess at par with their male colleagues when it came to bariatrics surgical intervention.
ABSTRACT
Background: Medical workers, including surgical professionals working in COVID-19 treating hospitals, were under enormous stress during The pandemic. This global study investigated factors endowing COVID amongst surgical professionals and students. Method(s): This global cross-sectional survey was made live on The 18th of February, 2021, and closed for analysis on The 13th of March, 2021. It was freely shared on social and scientific media platforms. It was also sent via email groups and circulated through a personal network of authors. Chi-square test for independence, binary logistic regression analysis was carried on determining predictors of surgical professionals contracting COVID-19. Result(s): This survey captured The response of 520 respondents from 66 countries. 92.29% (503/545) were working in ahospital receiving patients with COVID-19. More than one-fourth (25.5%) caught COVID-19, which was more frequent in participants working in public sector hospitals (P=0.001). 75.7% of those who did not contract COVID (283/376) were vaccinated (P<0.001). Surgical professionals undergoing practice in The private sector (OR: 0.33;95% CI: 0.14-0.77;p=0.011) and getting two doses of vaccines (OR: 0.55;95% CI: 0.32-0.95;p=0.031) had decreased odds of contracting COVID-19. only 6.9% of those who reported not contracting COVID-19 (26/376) were calculated to have The highest Level of Harm score (LH4) (P<0.001). Conclusion(s): High prevalence of respondents caught COVID-19, which was more frequent in participants working in public sector hospitals. Self-isolation or shield, getting two doses of vaccines decreases The odds of contracting COVID-19. Those who reported contracting COVID-19 were calculated to have The highest Level of Harm score.
ABSTRACT
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has massively affected bariatric surgical practises across the world. Aim: This report aims to show the effects of the pandemic on bariatric practices in the UK during the early phase of the pandemic. Methods: Bariatric surgeons in United Kingdom (UK) were contacted;seven bariatric units and 20 collaborators agreed to participate in this project. The data includes patients' demographics, type and number of operations, bariatric endoscopic procedures, management of complications, emergency and revisional bariatric surgery. Statistical analysis was used to assess the differences among the categories and to compare the data to the 6th report outcomes provided by British Obesity and the Metabolic Surgery Society 2017-2018 (NBSR). Further analysis of mortality between pre pandemic era and June 2020-June 2021 was performed. Results: A total of 430 bariatric procedures were conducted from 1 January 2020 to 31 March 2020 in seven hospitals in UK. The mean age of the patients was 43.3 years. The mean body mass index was 46.75 kg/m2. 314 (73%) of the patients were women and 116 (27%) were men. The following procedures were performed: 118 (27.4%) Laparoscopic Sleeve Gastrectomy (LSG), 114 (26.5%) One Anastomosis Gastric Bypass (OAGB), 76 (17.6%) Roux En-Y Gastric Bypass (RYGB), 61 (14.18%) Gastric Balloon and 15 (3.5%) Adjustable Gastric Band. 176 bariatric endoscopy procedures were performed for different indications. 26 (6.04%) revisional surgeries and 20 (4.6%) emergency bariatric surgeries were performed. 24 (5.58%) patients had Grade I-IV Clavien-Dindo complications. No mortality was reported. There was a significant difference in the number of operations for each of LSG, RYGB and OAGB in these seven hospitals compared to the data provided by the British Obesity and Metabolic Surgery Society (BOMSS) 2017-2018 .Only one patient was diagnosed with COVID-19, who was successfully treated and discharged home. Only one mortality was reported during June 2020 untill June 2021.There was no significant difference in moratlity between pre and post pandemic, p>0.5. Conclusions: This data reveals safe bariatric practices during the early phase of COVID-19. Copyright © Celsius Publishing House.