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

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Pulmonary function testMorbid obesityObesityBariatric surgeryComplications

Abbreviations

ASA

American Society of Anesthesiologists

BMI

Body mass index

COPD

Chronic obstructive pulmonary disease

ESS

Epworth sleepiness scale

FeNO

Exhaled nitric oxide

FEV1

Forced expiratory volume in 1 s

FRC

Functional respiratory capacity

FVC

Forced vital capacity

GERD

Gastroesophageal reflux disease

OSAS

Obstructive sleep apnea syndrome

RV

Residual volume

TLC

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