The recommendations of the Brazilian College of Surgeons and the Brazilian Bariatric and Metabolic Surgery Societies on the return of bariatric and metabolic operations in geographic regions of the country where the procedures have been allowed by local policies, in the period of COVID-19 pandemic

Abstract

<jats:p>ABSTRACT Prioritizing surgical procedures aims at facilitating patient’s access according to the clinical needs, maximizing access equity, and minimizing the damage from delayed access. Previous categorization of elective bariatric surgery have been adapted to define an objective prioritizing system that reflects those principles for bariatric and metabolic operations. Given the factors that contribute to the morbidity and mortality of obese and type 2 diabetes patients, surgical prioritization should be based on clinical risk stratification. For patients with type 2 diabetes, we suggest that the operation may be prioritized for those with a higher risk of morbidity and mortality in a relatively short term. Likewise, it is necessary to guide the surgical team regarding the necessary care both in the pre, per and postoperative periods of bariatric and metabolic surgery. These recommendations aim to reduce the risk of in-hospital contamination of the surgical team among health professionals and between health professionals and patients. In summary, these recommendations have been shaped after a thorough analysis of the available literature and are extremely important to mitigate the harm related to the clinical complications of obesity and its comorbidities while keeping healthcare providers’ and patients’ safety.</jats:p>

Chest Computed Tomography for SARS-CoV-2 Screening before Bariatric and Metabolic Surgery during the COVID-19 Pandemic

“…Prior to conducting this study, the researchers took into account the recommendations issued by different professional groups such as the IFSO and ASMBS [5][6][7]26]. These groups considered BMS essential, and therefore the safety goals were met and adequate triage was performed to identify patients with potential SARS-CoV-2 infection.…”

Manifestações Gastrointestinais Diretas E Indiretas

“…There are argues whether we should test and how we should test COVID-19 patients in the elective surgery lines, whereas the delay in the beginning or in these patients' continuity treatment with non-emergency diseases, severe and / or chronicle may result in the increasement of the procedures morbidity and mortality initially addressed as elective (23) .…”

“…The Brazilian Society of Bariatric and Metabolic Surgery (2020), for instance, requested joint organization priority to resumption of calls during a pandemic. It was determined that all candidates to digestive tract surgery and bariatric and metabolic surgery should be placed in a single list for elective procedure, however not prioritizing the arrival order but the clinical needs and severe cases (23).…”

“…The pandemic impacted other surgery procedures on the gastrointestinal system, to this extent the Brazilian Surgeon College and The Brazilian Society of Bariatric and Metabolic Surgery revised their determinations during the peak of the pandemic in Brazil (23) .…”

Vigilância em saúde na pandemia da COVID-19: retomada das atividades eletivas em rede de hospitais de ensino

“…Em um primeiro momento, considerando a alta transmissibilidade e infectividade do SARS-Cov-2, o contexto de transmissão comunitária instaurado em muitos territórios e o pouco conhecimento limitado sobre o tratamento da doença, algumas atividades assistenciais eletivas foram reprogramadas nos contextos hospitalares brasileiros 3,4,5 .…”