Preoperative Screening and Treatment of OSA Is Like Using a Sledgehammer for Cracking Nuts
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When discussing the perioperative management of obstructive sleep apnea (OSA) in metabolic surgery, most of us physicians agree on at least four things: (1) when left untreated, OSA is detrimental to the health of our patients; (2) prevalence of OSA in a bariatric population can be up to 80% in some studies; (3) moderate or severe OSA is a risk factor in the early postoperative period; and (4) after metabolic surgery, OSA resolves in up to 98% of the patients without any additional treatment [1, 2]. With these assumptions in mind and metabolic surgery being around for so many years, one would expect that perioperative management of OSA in metabolic patients is obvious. Unfortunately, the opposite is true.
The proper preoperative workup of a metabolic patient in general is still a topic of discussion at conferences and in guidelines [2, 3, 4]. At the core of the discussion lies the balance between too much or too little diagnostics. Too much is expensive and impedes the flow toward...
The authors would like to thank Dr. Marina Kurian, MD, for revising the manuscript.
Compliance with Ethical Standards
Both FJB and EOA formerly worked as metabolic surgeons in the Rijnstate Hospital, the Netherlands. The Rijnstate Hospital is the hospital where the study of van Veldhuisen et al. was conducted. EOA is also one of the co-authors. Both authors have no financial conflicts of interest.
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