SOFFCO-MM guidelines for the resumption of bariatric and metabolic surgery during and after the Covid-19 pandemic

Kassir, Radwan; Rebibo, L.; Genser, Laurent; Sterkers, Adrien; Blanchet, Marie-Cécile; Pattou, François; Msika, Simon; Abittan, R.; Abou-Mrad, Adel; Arnalsteen, Laurent; Arnoux, R; Auguste, Tamika; Benchetrit, S.; Berthet, B.; Bertrand, Jean-Baptiste; Blanchard, L.-C.; Bouillot, Jean‐Luc; Caïazzo, Robert; Catheline, Jean-Marc; Chevallier, Jean Marc; Dargent, J.; Fournier, Pierre; Frering, Vincent; Gugenheim, Jean; Johanet, H; Lechaux, D.; Leyre, P.; Liagre, Arnaud; Mouïel, J; Nocca, David; Pourcher, Guillaume; Reche, Fabián; Robert, Margaux; Sebbag, Hugues; Sodji, M.; Tuyeras, G.; Zimmermann, Juergen

doi:10.1016/j.jviscsurg.2020.06.005

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…Considering the increased risks for severe forms of COVID-19 infection that obesity engenders and the protective role of bariatric surgery in avoiding invasive mechanical ventilation and death, the pressure to return to normal activity for bariatric surgery was important. The resumption of bariatric surgery following the first peak of COVID-19 infections was controlled by several guidelines [ 8 , 16 , 17 , 18 ]. All these recommendations focused on the preoperative work-up for bariatric surgery and COVID-19 and on perioperative measures to avoid contamination.…”

Section: Discussionmentioning

confidence: 99%

Bariatric surgery in patients with previous COVID-19 infection

Nedelcu

Marx²,

Lutfi³

et al. 2021

Surgery for Obesity and Related Diseases

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Background The process of reintroducing bariatric surgery to our communities in a COVID-19 environment was particular to each country. Furthermore, no clear recommendation was made for patients with a previous COVID-19 infection and a favorable outcome who were seeking bariatric surgery. Objectives To analyze the risks of specific complications for patients with previous COVID-19 infection who were admitted for bariatric surgery. Setting Eight high-volume private centers from 5 countries. Methods All patients with morbid obesity and previous COVID-19 infection admitted for bariatric surgery were included in the current study. Patients were enrolled from 8 centers and 5 countries, and their electronic health data were reviewed retrospectively. The primary outcome was to identify early (<30 d) specific complications related to COVID-19 infection following bariatric surgery, and the secondary outcome was to analyze additional factors from work-ups that could prevent complications. Results Thirty-five patients with a mean age of 40 years (range, 21–68 yr) and a mean body mass index of 44.3 kg/m 2 (±7.4 kg/m 2 ) with previous COVID-19 infection underwent different bariatric procedures: 23 cases of sleeve (65.7 %), 7 cases of bypass, and 5 other cases. The symptomatology of the previous COVID-19 infection varied: 15 patients had no symptoms, 12 had fever and respiratory signs, 5 had only fever, 2 had digestive symptoms, and 1 had isolated respiratory signs. Only 5 patients (14.2 %) were hospitalized for COVID-19 infection, for a mean period of 8.8 days (range, 6–15 d). One patient was admitted to an intensive care unit and needed invasive mechanical ventilation. The mean interval time from COVID-19 infection to bariatric surgery was 11.3 weeks (3–34 wk). The mean hospital stay was 1.7 days (±1 d), and all patients were clinically evaluated 1 month following the bariatric procedure. There were 2 readmissions and 1 case of complication: that case was of a gastric leak treated with laparoscopic drainage and a repeated pigtail drain, with a favorable outcome. No cases of other specific complications or mortality were recorded. Conclusion Minor and moderate COVID-19 infections, especially the forms not complicated with invasive mechanical ventilation, should not preclude the indication for bariatric surgery. In our experience, a prior COVID-19 infection does not induce additional specific complications following bariatric surgery.

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Section: Discussionmentioning

confidence: 99%

Bariatric surgery in patients with previous COVID-19 infection

Nedelcu

Marx²,

Lutfi³

et al. 2021

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

show abstract

“… 29 When surgeries can resume, it has been proposed to stratify PwO based on a benefit/risk assessment with priority for those PwO whose need for surgery is high provided that the risk of morbidity due to the surgery is very low. 30 Increased vigilance, priority on COVID‐19 detection and testing, and aggressive therapy are recommendations for PwO and COVID‐19 infections. 23 …”

Section: Introductionmentioning

confidence: 99%

“…A recent publication by Rubino et al, provides comprehensive recommendations for prioritizing and managing surgical candidates and post‐operative patients during and after the peak of COVID‐19 waves, including pre‐operative screening, non‐surgical interventions and triaging of patients for priority surgery 29 . When surgeries can resume, it has been proposed to stratify PwO based on a benefit/risk assessment with priority for those PwO whose need for surgery is high provided that the risk of morbidity due to the surgery is very low 30 . Increased vigilance, priority on COVID‐19 detection and testing, and aggressive therapy are recommendations for PwO and COVID‐19 infections 23 …”

Section: Introductionmentioning

confidence: 99%

The impact of COVID‐19 on obesity services across Europe: A physician survey

Nather¹,

Bolger²,

DiModica³

et al. 2021

Clinical Obesity

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Summary Obesity is a risk factor for severe complications from coronavirus disease 2019 (COVID‐19). During the COVID‐19 pandemic in Spring 2020, many clinics and obesity centers across Europe were required to close. This study aimed to determine the impact of COVID‐19 on the provision of obesity services across 10 European countries via a survey of physicians (n = 102) specializing in treating persons with obesity (PwO). In total, 62–95 out of 102 physicians reported that COVID‐19 affected obesity‐related services, with cancellations/suspensions ranging from 50% to 100% across the 10 countries. Approximately 75% of cancellations/suspensions were provider‐ rather than patient‐initiated. A median increase of 20%–25% in waiting times was reported for most services across the countries. When services resume, 87 out of 100 physicians consider factors influencing down‐stream patient outcomes as the most relevant factors for prioritizing interventional treatment. Responses showed that 65 out of 102 and 36 out of 102 physicians believed it (highly) likely that a change in treatment guidance will occur to prioritize earlier interventional treatment for the management of PwO, by either using bariatric surgery or pharmacotherapy, respectively. Results from this study provide important learnings, such as opportunities for, and discrepancies in, the provision of alternative care in light of services cancellations or delays, which may be important for the future management of obesity, especially during future waves of COVID‐19 or other infectious pandemics.

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“…Last spring, the SOFFCO-MM drew up recommendations aimed at helping practitioners to prioritise patients according to the local health-care context ( Fig. 1 ) [7] . This document is meant to be of practical assistance.…”

mentioning

confidence: 99%