Department of Surgery, Tampere University Hospital Hatanpää, PL2000, FIN-33521, Tampere, Finland.
Päijät-Häme Central Hospital, 15850, Lahti, Finland.
Obes Surg. 2024 May;34(5):1544-1551. doi: 10.1007/s11695-024-07124-5. Epub 2024 Mar 8.
The prevalence of obstructive sleep apnea (OSA) is high among the bariatric surgery candidates. Obesity is the most important individual risk factor for OSA. The aim of this study was to investigate the effect of a laparoscopic Roux-en-Y gastric bypass (LRYGB) on OSA 5 years after the surgery.
In this prospective multicenter study, standard overnight cardiorespiratory recording was conducted to 150 patients at baseline prior to bariatric surgery. A total of 111 (73.3%) patients of those had OSA. Cardiorespiratory recordings at 5 years after surgery were available for 70 OSA patients. The changes in anthropometric and demographic measurements including age, weight, body mass index (BMI), and waist and neck circumference were evaluated. Also, a quality of life (QoL) questionnaire 15D administered in a baseline was controlled at 5-year follow-up visit.
At 5-year OSA was cured in 55% of patients, but moderate or severe OSA still persisted in 20% of patients after operation. Mean total AHI decreased from 27.8 events/h to 8.8 events/h (p < 0.001) at 5-year follow-up. A clinically significant difference in QoL was seen in mobility, breathing, sleeping, usual activities, discomfort and symptoms, vitality and sexual activity. The QoL total score improved more in OSA patient at 5-year follow-up.
LRYGB is an effective treatment of OSA in obese patients and the achieved beneficial outcomes are maintained at 5-year follow-up.
肥胖症手术候选人群中阻塞性睡眠呼吸暂停（OSA）的患病率较高。肥胖是 OSA 的最重要个体危险因素。本研究旨在探讨腹腔镜 Roux-en-Y 胃旁路术（LRYGB）对术后 5 年 OSA 的影响。
在这项前瞻性多中心研究中，在肥胖症手术前对 150 名患者进行了标准的过夜心肺记录。其中有 111 名（73.3％）患者患有 OSA。有 70 名 OSA 患者可获得术后 5 年的心肺记录。评估了包括年龄、体重、体重指数（BMI）、腰围和颈围在内的人体测量和人口统计学测量的变化。此外，还在基线时控制了 15D 生活质量（QoL）问卷，并在 5 年随访时进行了随访。
在 5 年时，55％的患者 OSA 得到治愈，但手术后仍有 20％的患者患有中度或重度 OSA。平均总 AHI 从 27.8 次/小时降至 5 年随访时的 8.8 次/小时（p <0.001）。在移动性、呼吸、睡眠、日常活动、不适和症状、活力和性功能方面，QoL 有明显改善。在 5 年随访时，OSA 患者的 QoL 总分提高更多。
LRYGB 是肥胖患者 OSA 的有效治疗方法，并且在 5 年随访时仍能保持有益的效果。
