Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery

Merve Ayık Türk

Research Article

Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery

Year 2025, Volume: 9 Issue: 1, 108 - 113, 21.04.2025

Merve Ayık Türk

Abstract

Purpose: The value of preoperative spirometry in laparoscopic obesity surgery is a subject of debate. The aim of our study is to investigate the relationship between preoperative pulmonary function tests (PFT) and postoperative pulmonary complications.

Materials and Methods: The study included 73 patients who were evaluated in the pulmonology department before bariatric surgery at a training and research hospital in Izmir, Turkey. Demographic data, pulmonary function, and postoperative complications were retrospectively analyzed.

Results: Seventeen patients (23.3%) had abnormal preoperative PFT results, while postoperative complications occurred in 7 patients (9.6%). Age, gender, surgery duration, and abnormal pulmonary function patterns were found to be significant factors in the development of complications (p=0.026, 0.047, 0.004, and 0.024, respectively). In multivariate analysis, surgery duration was identified as statistically significant in relation to complications (p=0.009).

Conclusion: These findings suggest that patients with abnormalities in preoperative PFT may have an increased risk of postoperative complications. In this context, preoperative PFT assessment in bariatric surgery could influence surgical and postoperative monitoring decisions, especially for patients at higher risk of complications.

Keywords

laparoscopic bariatric surgery, preoperative, pulmonary complications, spirometry

Ethical Statement

This is a retrospective study. Local ethical approval was received with the ethical approval date and number 27.03.24/09.

Supporting Institution

none.

Thanks

None.

References

1. Mechanick JI, Apovian C, Brethauer S, et al. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures - 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists : Executive Summary. Endocr Pract. 2019;25(12):1346-1359.
2. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-781.
3. Ogden C, Carroll M, Kit B, et al. Prevalence of obesity in the United States, 2009-2010. NCHS Data Brief. 2012;82:1-8.
4. Powell-Wiley TM, Poirier P, Burke LE, et al. American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):984-1010.
5. Bendor CD, Bardugo A, Pinhas-Hamiel O, et al. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol. 2020;19(1):79.
6. Behazin N, Jones SB, Cohen RI, et al. Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity. J Appl Physiol. 2010;108(1): 212-218.
7. Van Huisstede A, Biter LU, Luitwieler R, et al. Pulmonary function testing and complications of laparoscopic bariatric surgery. Obes Surg. 2013;23(10): 1596-1603.
8. Hamoui N, Anthone G, Crookes PF. The value of pulmonary function testing prior to bariatric surgery. Obes Surg. 2006;16(12):1570-1573.
9. Clavellina-Gaytán D, Velázquez-Fernández D, Del-Villar E, et al. Evaluation of spirometric testing as a routine preoperative assessment in patients undergoing bariatric surgery. Obes Surg. 2015;25(3):530-536.
10. Peterson CM, Thomas DM, Blackburn GL, et al. Universal equation for estimating ideal body weight and body weight at any BMI. Am J Clin Nutr. 2016;103(5):1197-1203.
11. Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J. 2022;60(1):2101499.
12. Canet J, Gallart L, Gomar C, et al; ARISCAT Group. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010;113(6):1338-1350.
13. Koenig SM. Pulmonary complications of obesity. Am J Med Sci. 2001;321(4):249-279.
14. Blouw EL, Rudolph AD, Narr BJ, et al. The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass. AANA J. 2003;71(1): 45-50.
15. Gonzalez R, Bowers SP, Venkatesh KR, et al. Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17:1900-1904.
16. Qaseem A. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing non-cardiothoracic surgery: a guideline from the American College of Physicians. Ann Inter Med. 2006;144(7):575-580.
17. Weller WE, Rosati C, Hannan EL. Predictors of in-hospital postoperative complications among adults undergoing bariatric procedures in New York State. Obes Surg. 2003;16(6):702-708.
18. Blouw EL, Rudolph AD, Norr BJ, et al. The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass. AANA J. 2003;71(1): 45-50.
19. Masoomi H, Reavis KM, Smith BR, et al. Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006-2008. Surg Obes Relat Dis. 2013;9(2):277-281.
20. Gupta PK, Gupta H, Kaushik M, et al. Predictors of pulmonary complications after bariatric surgery. Surg Obes Relat Dis. 2012;8(5):574-581.
21. Pantel H, Hwang J, Brams D, et al. Effect of Incentive Spirometry on Postoperative Hypoxemia and Pulmonary Complications After Bariatric Surgery: A Randomized Clinical Trial. JAMA Surg. 2017;152 (5):422-428.
22. Jogiat U, Mocanu V, Birch DW, et al. Pulmonary Complications Are a Strong Independent Predictor of 30-Day Mortality Following Elective Bariatric Surgery. Obes Surg. 2022;32(3):696-703.

Laparoskopik Obezite Cerrahisinde Preoperatif Solunum Fonksiyon Testi Parametreleri ile Postoperatif Pulmoner Komplikasyonlar Arasındaki İlişki

Year 2025, Volume: 9 Issue: 1, 108 - 113, 21.04.2025

Merve Ayık Türk

Abstract

Amaç: Laparoskopik obezite cerrahisinde preoperatif spirometrinin değeri tartışmalı bir konudur. Çalışmamızın amacı, preoperatif solunum fonksiyon testleri (SFT) ile postoperatif pulmoner komplikasyonlar arasındaki ilişkiyi araştırmaktır.

Araçlar ve Yöntem: Çalışmaya İzmir'deki bir eğitim ve araştırma hastanesinde bariatrik cerrahi öncesinde göğüs hastalıkları bölümünde değerlendirilen 73 hasta dahil edildi. Demografik veriler, SFT verileri ve postoperatif pulmoner komplikasyonlar retrospektif olarak analiz edildi.

Bulgular: On yedi hastanın (%23.3) preoperatif SFT'sinde anormal pulmoner fonksiyon paterni saptandı ve 7 hastada ise (%9.6) postoperatif pulmoner komplikasyon izlendi. Yaş, cinsiyet, cerrahi süresi ve anormal pulmoner fonksiyon paternlerinin komplikasyon gelişiminde anlamlı faktörler olduğu bulundu (sırasıyla, p=0.026, 0.047, 0.004 ve 0.024). Çok değişkenli analizde, cerrahi süresi komplikasyonlarla ilişkili bulundu (p=0.009).

Sonuç: Bu bulgular, preoperatif SFT'de anormal pulmoner fonksiyon paternine sahip hastaların postoperatif komplikasyon riskinin artabileceğini göstermektedir. Bu bağlamda, bariatrik cerrahide preoperatif SFT değerlendirmesi, özellikle komplikasyon riski daha yüksek olan hastalar için cerrahi ve postoperatif izleme kararlarını etkileyebilir.

Keywords

laparoskopik bariatrik cerrah, pulmoner komplikasyonlar, preoperatif, spirometri

References

1. Mechanick JI, Apovian C, Brethauer S, et al. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures - 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists : Executive Summary. Endocr Pract. 2019;25(12):1346-1359.
2. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-781.
3. Ogden C, Carroll M, Kit B, et al. Prevalence of obesity in the United States, 2009-2010. NCHS Data Brief. 2012;82:1-8.
4. Powell-Wiley TM, Poirier P, Burke LE, et al. American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):984-1010.
5. Bendor CD, Bardugo A, Pinhas-Hamiel O, et al. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol. 2020;19(1):79.
6. Behazin N, Jones SB, Cohen RI, et al. Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity. J Appl Physiol. 2010;108(1): 212-218.
7. Van Huisstede A, Biter LU, Luitwieler R, et al. Pulmonary function testing and complications of laparoscopic bariatric surgery. Obes Surg. 2013;23(10): 1596-1603.
8. Hamoui N, Anthone G, Crookes PF. The value of pulmonary function testing prior to bariatric surgery. Obes Surg. 2006;16(12):1570-1573.
9. Clavellina-Gaytán D, Velázquez-Fernández D, Del-Villar E, et al. Evaluation of spirometric testing as a routine preoperative assessment in patients undergoing bariatric surgery. Obes Surg. 2015;25(3):530-536.
10. Peterson CM, Thomas DM, Blackburn GL, et al. Universal equation for estimating ideal body weight and body weight at any BMI. Am J Clin Nutr. 2016;103(5):1197-1203.
11. Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J. 2022;60(1):2101499.
12. Canet J, Gallart L, Gomar C, et al; ARISCAT Group. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010;113(6):1338-1350.
13. Koenig SM. Pulmonary complications of obesity. Am J Med Sci. 2001;321(4):249-279.
14. Blouw EL, Rudolph AD, Narr BJ, et al. The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass. AANA J. 2003;71(1): 45-50.
15. Gonzalez R, Bowers SP, Venkatesh KR, et al. Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17:1900-1904.
16. Qaseem A. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing non-cardiothoracic surgery: a guideline from the American College of Physicians. Ann Inter Med. 2006;144(7):575-580.
17. Weller WE, Rosati C, Hannan EL. Predictors of in-hospital postoperative complications among adults undergoing bariatric procedures in New York State. Obes Surg. 2003;16(6):702-708.
18. Blouw EL, Rudolph AD, Norr BJ, et al. The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass. AANA J. 2003;71(1): 45-50.
19. Masoomi H, Reavis KM, Smith BR, et al. Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006-2008. Surg Obes Relat Dis. 2013;9(2):277-281.
20. Gupta PK, Gupta H, Kaushik M, et al. Predictors of pulmonary complications after bariatric surgery. Surg Obes Relat Dis. 2012;8(5):574-581.
21. Pantel H, Hwang J, Brams D, et al. Effect of Incentive Spirometry on Postoperative Hypoxemia and Pulmonary Complications After Bariatric Surgery: A Randomized Clinical Trial. JAMA Surg. 2017;152 (5):422-428.
22. Jogiat U, Mocanu V, Birch DW, et al. Pulmonary Complications Are a Strong Independent Predictor of 30-Day Mortality Following Elective Bariatric Surgery. Obes Surg. 2022;32(3):696-703.

There are 22 citations in total.

Details

Primary Language	English
Subjects	Chest Diseases
Journal Section	Original Articles
Authors	Merve Ayık Türk 0000-0003-3106-7403
Early Pub Date	April 16, 2025
Publication Date	April 21, 2025
Submission Date	November 18, 2024
Acceptance Date	December 31, 2024
Published in Issue	Year 2025 Volume: 9 Issue: 1

Cite

APA	Ayık Türk, M. (2025). Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery. Ahi Evran Medical Journal, 9(1), 108-113.
AMA	Ayık Türk M. Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery. Ahi Evran Med J. April 2025;9(1):108-113.
Chicago	Ayık Türk, Merve. “Relationship Between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery”. Ahi Evran Medical Journal 9, no. 1 (April 2025): 108-13.
EndNote	Ayık Türk M (April 1, 2025) Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery. Ahi Evran Medical Journal 9 1 108–113.
IEEE	M. Ayık Türk, “Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery”, Ahi Evran Med J, vol. 9, no. 1, pp. 108–113, 2025.
ISNAD	Ayık Türk, Merve. “Relationship Between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery”. Ahi Evran Medical Journal 9/1 (April 2025), 108-113.
JAMA	Ayık Türk M. Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery. Ahi Evran Med J. 2025;9:108–113.
MLA	Ayık Türk, Merve. “Relationship Between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery”. Ahi Evran Medical Journal, vol. 9, no. 1, 2025, pp. 108-13.
Vancouver	Ayık Türk M. Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery. Ahi Evran Med J. 2025;9(1):108-13.

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