Abstract
Background
Obstructive sleep apnea syndrome (OSAS) is prevalent among morbidly obese patients.
Evaluation of the specific effects of sleeve gastrectomy (SG) on upper airway function
has not been reported. Given the possibility that some patients will not respond despite
weight loss, no studies have investigated whether other mechanisms may be responsible
for persistent OSAS after bariatric surgery.
Objectives
To evaluate by subjective and objective assessment the impact of SG on upper respiratory
physiology in the long-term.
Setting
University Hospital, Division of Bariatric and ENT Surgery, in Italy.
Methods
Thirty-six consecutive patients with OSAS who underwent laparoscopic SG were prospectively
enrolled. The effect of SG on respiratory function and OSAS was followed for 5 years.
Results
All patients completed the 5-year follow-up. A significant (P<.001) improvement in modified Epworth Sleepiness Scale questionnaire (ESS) was obtained
in 91.6% (33/36) of patients. The Apnea/Hypopnea index (AHI) improved in 80.6% (29/36)
of patients after surgery (from 32.8±1.7 to 5.8±1.2 (P<.001), 4.9±1.7). The remaining 19.4% (7/36) of patients with a positive ESS and/or
AHI all had an associated respiratory resistance due to nasal obstructive diseases.
Conclusion
SG improved OSAS overall, but patients who did not improve or only partially improved
despite weight loss were found to have an associated nasal responsible pathology.
How these patients will respond to nasal surgery and whether a 2-step procedure should
be recommended for OSAS patients requires further study.
Keywords
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Article info
Publication history
Published online: March 04, 2015
Accepted:
February 24,
2015
Received:
January 9,
2015
Identification
Copyright
© 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
