Outcomes of reoperative surgery in severely obese patients after sleeve gastrectomy: a single-institution experience

Background: The repeated episode of obstructive hypopnea and apnea during sleep is defined as obstructive sleep apnea (OSA) and it is a common condition in obese patients. Studies performing bariatric surgery have demonstrated a significant improvement in OSA by weight reduction. In this prospective study we aimed to explore the efficacy and safety of Laparoscopic Sleeve Gastrectomy (LSG) on OSAS among severely obese patients. Material and Methods: A total of 32 morbidly obese patients who underwent LSG for morbid obesity were included in this study. Body weight, height, body mass index (BMI) and standard overnight polysomnography (PSG) were measured at before and after LSG at the 6th month.  Results: 32 patients (27 female, 5 male) who have postoperative PSG's were included in this study. The mean age was 43.22±9.87 years old. The mean preoperative and postoperative BMIs were 50.36±8.14kg/m² and 37.27±7.93kg/m², respectively. The mean Epworth sleepiness scale determined as 5.84±4.65 preoperatively and 2.19±3.55 postoperatively. The preoperative and postoperative sleep efficiency test of the patients was determined as 83.34±9.68 and 88.94±6.90 respectively. AHI average at the preoperative PSG was 31.47±26.34, while 9.35±10:34 at postoperative 6 months and found as statistically significant. Conclusion: Our data showed that LSG is an efficient and safe procedure on severely obese patients and showed a predictive remission of clinical and sleep parameters of patients with OSA by analyzing PSG data during the first 6 months.

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Laparoscopic sleeve gastrectomy under general anesthesia in severely obese patients: a single-centered retrospective study

PeerJ ◽

10.7717/peerj.10802 ◽

2021 ◽

Vol 9 ◽

pp. e10802

Author(s):

Yuanyuan Ma ◽

Yu Fan ◽

Di Zhou ◽

Junjun Chen ◽

Shengjin Ge

Keyword(s):

Sleeve Gastrectomy ◽

General Anesthesia ◽

Laparoscopic Sleeve Gastrectomy ◽

Polycystic Ovary ◽

Operation Time ◽

Perioperative Period ◽

General Information ◽

Obese Patients ◽

Multidisciplinary Collaboration ◽

Severely Obese

Background This study aims to summarize and analyze the clinical characteristics and outcomes of severely obese patients who underwent laparoscopic sleeve gastrectomy (LSG) under general anesthesia with multidisciplinary collaboration. Methods A retrospective analysis was performed for 100 severely obese patients who were hospitalized in Zhongshan Hospital, Fudan University from January 2017 to December 2019, and included preoperative general information, laboratory examinations, anesthesia and outcomes. Results A total of 100 patients (46 males, 54 females) were admitted to the department of endocrinology: 100 had hepatic steatosis (100%), 43 had sleep apnea hypopnea syndrome (43%), 25 had hypertension (25%), 11 had type 2 diabetes (11%) and 8 had polycystic ovary syndrome (14% of women). The mean age and BMI were 31.52 ± 10.53 years and 43.31 ± 6.80 kg/m2, respectively. Visual laryngoscope intubation was successfully performed with routine intravenous induction in the optimum sniffing position at one time. The surgeries were successfully performed under general anesthesia, without conversion, and the operation time was 140.92 ± 31.23 min. The follow-up data for 41 patients were obtained. The postoperative BMI showed a downward trend. The BMI at 1 month and 3 months after surgery were 38.40 ± 6.77 kg/m2and 35.52 ± 7.94 kg/m2, respectively. Conclusions Multidisciplinary collaboration may contribute to better management and recovery during the perioperative period. Visual laryngoscope intubation with intravenous induction was performed successfully in the optimum sniffing position at one time.

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