Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695, Japan.
Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695, Japan.
Langenbecks Arch Surg. 2022 Nov;407(7):2747-2754. doi: 10.1007/s00423-022-02549-x. Epub 2022 May 19.
This study evaluated the improvement of respiratory function and airway volumes using spirometry and computed tomography (CT) in severely obese Japanese patients undergoing laparoscopic sleeve gastrectomy (LSG). We also evaluated the quality of life (QOL) of enrolled patients using questionnaires.
A total of 71 patients who underwent LSG at Iwate Medical University Hospital between October 2013 and September 2020 were enrolled. The changes and relationships between respiratory parameters including CT volumetry and weight-loss effects were evaluated. Improvements to QOL and bronchial asthma (BA) were also assessed before LSG and 1 year after LSG.
The mean excess weight loss percentage (%EWL) and total weight loss percentage (%TWL) were measured at 55.1% and 26.1%, respectively. The attack frequency of BA significantly decreased (6.1/month vs. 1.5/month; P < 0.001), and the disease severity decreased according to severity classification (P = 0.032). Almost spirometric parameters, lung volume (LV) (4905.0 mL vs. 5490.3 mL; P < 0.001), and airway volume (AV) (108.6 mL vs. 119.3 mL; P = 0.022) significantly improved. The change of functional residual capacity (FRC) was correlated with both %EWL (ρ = 0.69, P < 0.001) and %TWL (ρ = 0.62, P < 0.001). The increase of LV (ρ = 0.79, P < 0.001) and AV (ρ = 0.69, P < 0.001) were correlated with the increase of FRC. Scores of QOL questionnaires dramatically became better owing to improvements in dyspnea.
Weight loss effects and the reduction of body fat mass correlated significantly with increase in LV and AV. Improvements of respiratory functions after LSG contributes to QOL and BA symptoms.
本研究通过肺活量测定法和计算机断层扫描（CT）评估了严重肥胖的日本腹腔镜袖状胃切除术（LSG）患者的呼吸功能和气道容积的改善。我们还使用问卷评估了纳入患者的生活质量（QOL）。
共纳入 2013 年 10 月至 2020 年 9 月在岩手医科大学医院接受 LSG 的 71 例患者。评估了包括 CT 容积测量在内的呼吸参数的变化及其与减肥效果之间的关系。在 LSG 前和 LSG 后 1 年评估了 QOL 和支气管哮喘（BA）的改善情况。
平均超重减轻百分比（%EWL）和总体重减轻百分比（%TWL）分别为 55.1%和 26.1%。BA 的发作频率显著降低（6.1/月 vs. 1.5/月；P<0.001），根据严重程度分类，疾病严重程度降低（P=0.032）。几乎所有的肺活量测定参数、肺容积（LV）（4905.0 mL vs. 5490.3 mL；P<0.001）和气道容积（AV）（108.6 mL vs. 119.3 mL；P=0.022）均显著改善。功能残气量（FRC）的变化与%EWL（ρ=0.69，P<0.001）和%TWL（ρ=0.62，P<0.001）均相关。LV（ρ=0.79，P<0.001）和 AV（ρ=0.69，P<0.001）的增加与 FRC 的增加相关。由于呼吸困难的改善，QOL 问卷的评分显著提高。
减肥效果和体脂质量的减少与 LV 和 AV 的增加显著相关。LSG 后呼吸功能的改善有助于 QOL 和 BA 症状的改善。
