Literature DB >> 19640798

Continuous positive airway pressure in immediate postoperative period after laparoscopic Roux-en-Y gastric bypass: is it safe?

Alexander Ramirez1, Peter F Lalor, Samuel Szomstein, Raul J Rosenthal.   

Abstract

BACKGROUND: Obstructive sleep apnea is a common condition in the morbidly obese population. Many patients undergoing bariatric surgery require postoperative continuous positive airway pressure (CPAP) therapy. Few data have been published evaluating gastrointestinal anastomotic morbidity in patients receiving CPAP therapy immediately after laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of the present study was to examine the short-term morbidity of postoperative CPAP in patients after LRYGB in a research setting.
METHODS: We retrospectively reviewed a prospectively collected database of 310 patients who underwent LRYGB from June 2005 to August 2006. The hospital and office charts and respiratory treatment records were reviewed from the completion of surgery until the first postoperative visit at 2 weeks. The data collected included age, gender, body mass index, presence of obstructive sleep apnea, in-patient CPAP use, and perioperative complications. Patients were divided into 2 groups: those who used immediate postoperative CPAP therapy and those who did not. Patients requiring revisional surgery and other bariatric procedures were excluded from the present series.
RESULTS: Postoperative CPAP was required by 91 patients (29.3%) and 219 did not use CPAP (70.7%). The mean patient age was 47.2 and 43.9 years (P <.01), and the average body mass index was 52 and 46.4 kg/m(2) in the groups that did and did not require CPAP postoperatively, respectively (P <.0001). No anastomotic leaks occurred in either group, and the most common in-hospital complication, seen in 7 patients (2.2%), was basal atelectasis (3 in the postoperative CPAP group; P >.05), followed by wound infection in 4 patients overall (1.2%; 3 patients in the postoperative CPAP group; P >.05) and gastrointestinal bleeding in 1 patient (.32%) in the group without postoperative CPAP. The difference in overall morbidity, unrelated to the integrity of the anastomosis, between those who used CPAP postoperatively and those who did not was not significant (4.5% versus 3.6%, respectively; P >.05).
CONCLUSION: The use of CPAP after LRYGB did not result in increased the morbidity in our patient series.

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Year:  2009        PMID: 19640798     DOI: 10.1016/j.soard.2009.05.007

Source DB:  PubMed          Journal:  Surg Obes Relat Dis        ISSN: 1550-7289            Impact factor:   4.734


  7 in total

Review 1.  Controversies in perioperative anesthetic management of the morbidly obese: I am a surgeon, why should I care?

Authors:  Ashish C Sinha; Preet Mohinder Singh
Journal:  Obes Surg       Date:  2015-05       Impact factor: 4.129

2.  Letter to the Editor: Regarding The Evaluation of Screening Questionnaires for Obstructive Sleep Apnea to Identify High-Risk Obese Patients Undergoing Bariatric Surgery.

Authors:  Mark Friel
Journal:  Obes Surg       Date:  2019-01       Impact factor: 4.129

3.  Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery.

Authors:  Sebastian Zaremba; Christina H Shin; Matthew M Hutter; Sanjana A Malviya; Stephanie D Grabitz; Teresa MacDonald; Daniel Diaz-Gil; Satya Krishna Ramachandran; Dean Hess; Atul Malhotra; Matthias Eikermann
Journal:  Anesthesiology       Date:  2016-07       Impact factor: 7.892

4.  Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery.

Authors:  Jeffrey I Mechanick; Adrienne Youdim; Daniel B Jones; W Timothy Garvey; Daniel L Hurley; M Molly McMahon; Leslie J Heinberg; Robert Kushner; Ted D Adams; Scott Shikora; John B Dixon; Stacy Brethauer
Journal:  Obesity (Silver Spring)       Date:  2013-03       Impact factor: 5.002

5.  Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery.

Authors:  Jeffrey I Mechanick; Adrienne Youdim; Daniel B Jones; W Timothy Garvey; Daniel L Hurley; M Molly McMahon; Leslie J Heinberg; Robert Kushner; Ted D Adams; Scott Shikora; John B Dixon; Stacy Brethauer
Journal:  Endocr Pract       Date:  2013 Mar-Apr       Impact factor: 3.443

6.  Perioperative Risks of Untreated Obstructive Sleep Apnea in the Bariatric Surgery Patient: a Retrospective Study.

Authors:  Wing Tai Kong; Shawn Chopra; Michael Kopf; Carlos Morales; Shahzad Khan; Keith Zuccala; Laura Choi; John Chronakos
Journal:  Obes Surg       Date:  2016-12       Impact factor: 4.129

Review 7.  CPAP in the Perioperative Setting: Evidence of Support.

Authors:  Frances Chung; Mahesh Nagappa; Mandeep Singh; Babak Mokhlesi
Journal:  Chest       Date:  2016-01-12       Impact factor: 9.410

  7 in total

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