Obesity Surgery

, Volume 23, Issue 10, pp 1596–1603

Pulmonary Function Testing and Complications of Laparoscopic Bariatric Surgery

  • Astrid van Huisstede
  • Laser Ulas Biter
  • Ronald Luitwieler
  • Manuel Castro Cabezas
  • Guido Mannaerts
  • Erwin Birnie
  • Christian Taube
  • Pieter S. Hiemstra
  • Gert-Jan Braunstahl
Original Contributions

DOI: 10.1007/s11695-013-0928-9

Cite this article as:
van Huisstede, A., Biter, L.U., Luitwieler, R. et al. OBES SURG (2013) 23: 1596. doi:10.1007/s11695-013-0928-9



Obesity is associated with respiratory symptoms and impaired pulmonary function, which could increase the risk of complications after bariatric surgery. The purpose of this study is to assess the relationship between pulmonary function parameters before, and the risk of complications after, laparoscopic bariatric surgery.


This prospective study included patients (age 18–60, BMI >35 kg/m2), who were eligible for bariatric surgery. Spirometry was performed in all patients. Complications up to 30 days after bariatric surgery were recorded.


Four hundred eighty-five patients were included (304 laparoscopic sleeve gastrectomy, 181 laparoscopic gastric bypass). There were 53 complications (8 pulmonary, 27 surgical, 14 infectious, 4 other) in 50 patients (10 %). There were 35 re-admissions (7.2 %), and 17 re-laparoscopies (3.5 %). Subjects with and without complications did not differ significantly with respect to demographics, weight, BMI, abdominal circumference or fat percentage. Subjects with complications had a significantly lower mean FEV1 (mean 86.9 % predicted) and FVC (95.6 % predicted) compared to patients without complications (95.9 % predicted, p = 0.005, and 100.1 % predicted, p = 0.045, respectively). After adjustment for age, gender, BMI, and smoking, abnormal spirometry value remained the single predictive covariable of postoperative complications: FEV1/FVC <70 % adjusted OR 3.1 (95%CI 1.4–6.8, p = 0.006) and ΔFEV1 ≥12 % adjusted OR 2.9 (95 %CI 1.3–6.6, p = 0.010).


The risk of pulmonary complications after laparoscopic bariatric surgery is low. However, subjects with abnormal spirometry test results have a threefold risk of complications after laparoscopic bariatric surgery. Preoperative pulmonary function testing might be useful to predict the risk of complications of laparoscopic bariatric surgery.


Pulmonary function testMorbid obesityObesityBariatric surgeryComplications



American Society of Anesthesiologists


Body mass index


Chronic obstructive pulmonary disease


Epworth sleepiness scale


Exhaled nitric oxide


Forced expiratory volume in 1 s


Functional respiratory capacity


Forced vital capacity


Gastroesophageal reflux disease


Obstructive sleep apnea syndrome


Residual volume


Total lung capacity

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Astrid van Huisstede
    • 1
  • Laser Ulas Biter
    • 2
  • Ronald Luitwieler
    • 3
  • Manuel Castro Cabezas
    • 4
  • Guido Mannaerts
    • 2
  • Erwin Birnie
    • 5
    • 6
  • Christian Taube
    • 7
  • Pieter S. Hiemstra
    • 7
  • Gert-Jan Braunstahl
    • 1
  1. 1.Department of PulmonologySint Franciscus GasthuisRotterdamThe Netherlands
  2. 2.Department of SurgerySint Franciscus GasthuisRotterdamThe Netherlands
  3. 3.Department of AnesthesiologySint Franciscus GasthuisRotterdamThe Netherlands
  4. 4.Department of Internal MedicineSint Franciscus GasthuisRotterdamThe Netherlands
  5. 5.Department of StatisticsSint Franciscus GasthuisRotterdamThe Netherlands
  6. 6.Institute of Health Policy and ManagementErasmus University RotterdamRotterdamThe Netherlands
  7. 7.Department of PulmonologyLeiden University Medical CenterLeidenThe Netherlands