Laparoscopic Adrenal Gland Surgery in Times of COVID - Is a Safety-Interval Before Surgery After COVID-Infection Still Mandatory?

Background: Due to a multicenter study early in the coronavirus disease (COVID)-pandemic that revealed an increased risk for postoperative mortality, thromboembolic and pulmonary complications in case of surgery shortly after a COVID infection, current recommendations for planning elective surgeries suggest postponing surgery for at least 7 weeks after COVID infection. However, virus variants have evolved throughout the pandemic, leading to less severe symptoms. Besides, laparoscopic adrenal gland surgery itself is a safe procedure with low morbidity rates. Therefore, this study aimed to compare the perioperative course of patients undergoing laparoscopic adrenalectomy shortly after a COVID-19 infection with those who had not had a recent SARS-CoV-2 infection in 2022.

Patients, material, and methods: All patients who underwent laparoscopic adrenalectomy at the Department for General, Visceral and Transplantation Surgery at Ludwig-Maximilian University between January and December 2022 were included.

Results: There was no event of thromboembolic or pulmonary complications in the study population. Duration of surgery did not differ between the two groups; neither did the need for postoperative ICU-admittance nor the duration of ICU-stay. Intraoperative FiO₂ did not differ, nor did the SpO₂ or the number of different catecholamines. There was a slight trend towards higher noradrenaline dosage among patients after COVID-19 infection. Previous COVID infection did not lead to prolonged hospital stays.

Conclusion: The results demonstrate that in case of well-standardized surgical procedures, with a limited surgical trauma and the possibility for patients to be mobilized early, surgery shortly after a mild COVID infection seems safe and reasonable.