The Impact of Obstructive Sleep Apnea Severity on Laparoscopic Sleeve Gastrectomy Outcomes.

INTRODUCTION

Obstructive sleep apnea (OSA) is prevalent in patients with obesity and is a known risk factor for metabolic bariatric surgery (MBS). This study assessed the association between OSA severity and operative outcomes of laparoscopic sleeve gastrectomy (LSG) in a Japanese cohort.

METHODS

We analyzed 141 patients who underwent LSG, divided into two groups based on their apnea-hypopnea index (AHI): a high-AHI group (AHI ≥ 32 events/h; n = 70) and a low-AHI group (AHI < 32 events/h; n = 71). Perioperative outcomes and gastroesophageal reflux disease (GERD) were compared. Multivariable logistic regression was used to identify independent predictors of early postoperative complications.

RESULTS

Patient characteristics differed significantly, with higher BMI and a higher proportion of males in the high-AHI group. CPAP was utilized by 87% of patients in the high-AHI group versus 11% in the low-AHI group. There were no significant differences between groups regarding operative time, blood loss, or GERD improvement. Multivariable analysis showed that while AHI was a statistically significant independent predictor of early complications (OR 1.018, 95% CI 1.002-1.035, p = 0.024), its clinical impact was minimal. CPAP usage showed a trend toward risk reduction (OR 0.362, p = 0.172).

CONCLUSION

Severe OSA does not prohibitively increase perioperative risk when managed with appropriate preoperative CPAP therapy.