Recommendations for Metabolic and Bariatric Surgery During the COVID-19 Pandemic from IFSO
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EDITORIAL
Recommendations for Metabolic and Bariatric Surgery During the COVID-19 Pandemic from IFSO Wah Yang 1 & Cunchuan Wang 1 & Scott Shikora 2 & Lilian Kow 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Background
General Recommendations
Coronavirus disease 2019 (COVID-19) emerged in Wuhan City and rapidly spread throughout China and around the world since December 2019 [1]. The World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic on 11 March 2020 [2, 3]. Patients with metabolic disorders like cardiovascular diseases, diabetes and obesity may face a greater risk of infection of COVID-19 and it can also greatly affect the development and prognosis of pneumonia [1, 4–6]. In response to the COVID-19 pandemic outbreak, the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has issued these recommendations to our global healthcare providers aimed at keeping all our patients and practice staff in an as safe an environment as possible.
All elective surgical and endoscopic cases for metabolic and bariatric surgery should be postponed during the pandemic. This minimises risks to both patient and healthcare team, as well as reducing the utilisation of unnecessary resources, such as beds, ventilators and personal protective equipment (PPE). In addition, postponing these services will minimise potential exposure of the COVID-19 virus to unsuspecting healthcare providers and patients [7].
Wah Yang is President-elect of Young IFSO Cunchuan Wang is President-elect of IFSO-APC Scott Shikora is President-elect of IFSO Lilian Kow is President of IFSO * Cunchuan Wang [email protected] * Scott Shikora [email protected] * Lilian Kow [email protected] 1
Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital, Jinan University, Guangzhou, China
2
Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
3
Adelaide Bariatric Centre, Flinders Private Hospital, Bedford Park, Adelaide, South Australia, Australia
Screening and Diagnosis The body temperature of all patients upon arrival at endoscopy units, clinics or inpatient wards should be checked and documented. All admissions to hospital should be screened for COVID-19 by chest computed tomography (CT) scan and be confirmed by real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay for nasal and pharyngeal swab specimens [8–11]. COVID-19 should be diagnosed on the basis of the WHO interim guidance [12]. Isolation precautions should be taken for those awaiting test results. All patients should be asked about recent history of fever or respiratory symptoms, family members or close contacts with similar symptoms, any contact with a confirmed case of COVID-19 and recent travel to high-risk areas.
Emergency Surgery for Treating Postoperative Complications Only emergency surgeries for treating severe complications of bariatric surgery are recommended during the COVID-19 pandemic, for example postoperative bleeding, leak, etc. Howe
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