Emile Sameh Hany, Elgamal Mohamed, Elshobaky Ayman, Shalaby Mostafa, Fadaly Ahmed, AbdelMawla Ahmed, Elbanna Hosam Ghazy, Abdel-Razik Mohamed Anwar
General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt.
Department of Thoracic Medicine, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt.
J Laparoendosc Adv Surg Tech A. 2019 Nov;29(11):1456-1461. doi: 10.1089/lap.2019.0459. Epub 2019 Sep 19.
Morbid obesity is associated with variable degrees of pulmonary dysfunction that may predispose to postoperative complications. This study aimed to identify high risk patients to have pulmonary dysfunction before bariatric surgery in terms of age, sex, and body mass index (BMI) and the impact of pulmonary dysfunction on postoperative pulmonary complications. Prospective database of patients with morbid obesity who underwent bariatric surgery was reviewed. Data on patients' demographics, parameters of pulmonary function tests, and postoperative pulmonary complications were collected. The correlation between patients' age, sex and BMI, and pulmonary function was investigated using Pearson's correlation coefficient test. Ninety-seven patients (82 female) with morbid obesity were included in the study. Twenty-eight (28.9%) patients had pulmonary dysfunction. Patients >40 years had higher odds of pulmonary dysfunction than patients ≤40 years (odds ratio [OR]: 2.54, = .05). Male patients had significantly higher odds of pulmonary dysfunction than female patients (OR: 2.5, = .03). Patients with BMI >50 had significantly higher odds of pulmonary dysfunction than patients with BMI <50 (OR: 4.9, = .002). Patients with pulmonary dysfunction had significantly higher odds of developing pulmonary complications than patients with normal spirometry (OR: 9.13, = .009). Around 30% of patients undergoing bariatric surgery had pulmonary dysfunction. Pulmonary dysfunction in preoperative spirometry was able to predict postoperative pulmonary complications. Men, patients older than 40 years, and superobese individuals had higher odds of having pulmonary dysfunction and are at higher risk to develop pulmonary complications after bariatric surgery.
病态肥胖与不同程度的肺功能障碍相关，这可能易导致术后并发症。本研究旨在根据年龄、性别和体重指数（BMI）确定肥胖症手术前有肺功能障碍的高危患者，以及肺功能障碍对术后肺部并发症的影响。回顾了接受肥胖症手术的病态肥胖患者的前瞻性数据库。收集了患者的人口统计学数据、肺功能测试参数和术后肺部并发症的数据。使用Pearson相关系数检验研究患者年龄、性别和BMI与肺功能之间的相关性。97例病态肥胖患者（82例女性）纳入研究。28例（28.9%）患者有肺功能障碍。年龄>40岁的患者发生肺功能障碍的几率高于年龄≤40岁的患者（优势比[OR]：2.54，P = 0.05）。男性患者发生肺功能障碍的几率显著高于女性患者（OR：2.5，P = 0.03）。BMI>50的患者发生肺功能障碍的几率显著高于BMI<50的患者（OR：4.9，P = 0.002）。有肺功能障碍的患者发生肺部并发症的几率显著高于肺量计正常的患者（OR：9.13，P = 0.009）。约30%接受肥胖症手术的患者有肺功能障碍。术前肺量计检查中的肺功能障碍能够预测术后肺部并发症。男性、年龄大于40岁的患者和超级肥胖个体发生肺功能障碍的几率更高，且在肥胖症手术后发生肺部并发症的风险更高。
