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Sleeve Gastrectomy is Associated with Longitudinal Improvements in Lung Function and Patient-Reported Respiratory Outcomes

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Abstract

Purpose

Obesity exerts negative effects on pulmonary function through proven mechanical and biochemical pathways. Multiple studies have suggested that bariatric surgery can improve lung function. However, the timing of these effects on lung function and its association with patient reported outcomes is not known.

Materials and Methods

A prospective cohort study of patients undergoing laparoscopic sleeve gastrectomy (LSG) at a tertiary care hospital was undertaken. Spirometry tests, laboratory tests, and self-reported questionnaires on asthma symptoms and asthma control (ACQ and ACT) were administered. All data were recorded pre-operatively (T0) and every 3 months post-operatively for 1 year (T3, T6, T9, T12) and were compared using a mixed-models approach for repeated measures.

Results

For the 23 participants, mean age was 44.2 ± 12.3 years, mean BMI was 45.2 ± 7.2 kg/m2, 18(78%) were female, 9(39%) self-reported as non-white and 6(26%) reported to have asthma. Following LSG, % total body weight loss was significant at all follow-up points (P < 0.0001). Rapid improvement in forced expiratory volume (FEV)% predicted and forced vital capacity (FVC)% predicted was seen at T3. Although the overall ACQ and ACT score remained within normal range throughout the study, shortness of breath declined significantly at 3 months post-op (P < 0.05) and wheezing resolved for all patients by twelve months. Patients also reported reduced frequency of sleep interruption and inability to exercise by the end of the study (P < 0.05).

Conclusion

Improvements in objective lung function assessments and patient-reported respiratory outcomes begin as early as 3 months and continue until 12 months after sleeve gastrectomy.

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Data Availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at Mass General Brigham.

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Funding

This study was supported by a grant from the National Heart, Lung, and Blood Institute (NHLBI) at the U.S. National Institutes of Health (NIH) (K01 HL127265), an appointed KL2 award from Harvard Catalyst (The Harvard Clinical and Translational Science Center) and the NIH National Center for Advancing Translational Sciences (NCATS) (KL2TR002542) and research coordinator support from the BWH Center for Clinical Investigation via a grant from Harvard Catalyst and the NIH NCATS (UL1TR002541).

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Author notes

  1. Damien C. Croteau-Chonka and Eric G. Sheu contributed equally.

Authors and Affiliations

  1. Laboratory of Surgical and Metabolic Research, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Vasundhara Mathur, Mehran Karvar, Tammy Lo, Ali Tavakkoli & Eric G. Sheu

  2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Benjamin A. Raby & Damien C. Croteau-Chonka

  3. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Benjamin A. Raby

  4. Division of Pulmonary Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Benjamin A. Raby

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

D.C.C–C. is currently an employee at GlaxoSmithKline; A.T. is a cofounder and consultant for AltrixBio; and E.G.S has served as a consultant for Vicarious Surgical, Inc. and received educational support from Intuitive Surgical, Inc. and speaker fees from Cine-Med. All other authors declare no competing interests.

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Key Points

• Lung volumes increased significantly starting 3 months post-LSG.

• Frequency of shortness of breath and wheeze improved after LSG.

• Quality of sleep and exercise improved after LSG.

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Mathur, V., Karvar, M., Lo, T. et al. Sleeve Gastrectomy is Associated with Longitudinal Improvements in Lung Function and Patient-Reported Respiratory Outcomes. OBES SURG (2024). https://doi.org/10.1007/s11695-024-07274-6

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