Evaluation of OSAS in Patients Planned Bariatric Surgery Who Has Morbid Obesity

Abstract

Background: Before bariatric surgery, diagnosis of OSAS is vital for the prevention of both operative and postoperative complications. İn diagnosing of OSAS, polysomnography (PSG) is the gold-standard method, but it cannot be performed on all patients due to cost and time limitations. We aimed to determine the new predictive factors that we can use to identify patients on whom we will perform PSG.
Materials and Methods: Preoperative height, weight, body mass index (BMI), neutrophil-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet mass index (PMI), and platelet-lymphocyte ratio (PLR) of the patients were recorded. PSG was performed, and apnea-hypopnea indices (AHI) were determined. This process was repeated one year after the surgery.
Results: A laparoscopic sleeve gastrectomy (LSG) was performed in 57 patients. There were statistically significant differences regarding age, height, BMI, and PMI values between the patients with and without OSAS before surgery (P < 0.05). Also, statistically significant differences were detected in preoperative and postoperative BMI and PMI values of patients whose OSAS ultimately improved (P < 0.05).
Conclusions: LSG is an effective method to reduce weight and, therefore, to improve OSAS. Also, BMI and PMI parameters are the most important predictive values in predicting OSAS. PSG can be performed on selected patients based on predictive values.

Keywords

• Obesity
• obstructive sleep apnea
• polysomnography
• bariatric surgery
• platelet mass index
• Obesity, obstructive sleep apnea, polysomnography, bariatric surgery, platelet mass index

Bariatrik Cerrahi Planlanan Morbid Obezli Hastaların OSAS Açısından Değerlendirilmesi

Abstract

Amaç: Bariatrik cerrahi öncesi OUAS(Obstrüktif uyku apne sendromu) tanısı, hem operatif hem de postoperatif komplikasyonların önlenmesi için hayati önem taşımaktadır. Polisomnografi (PSG) OUAS tanısında altın standart yöntem olmasına rağmen maliyet ve zaman kısıtlılığı nedeniyle tüm hastalara uygulanamamaktadır. PSG uygulayacağımız hastaları belirlemek için kullanabileceğimiz yeni prediktif faktörleri belirlemeyi amaçladık. Gereç Ve Yöntem: Hastaların ameliyat öncesi boy, kilo, vücut kitle indeksi (VKİ), nötrofil-lenfosit oranı (NLO), ortalama trombosit hacmi (OTH), trombosit-lenfosit oranı (PLR) ve trombosit kitle indeksi (PKİ) kaydedildi. PSG yapıldı ve apne-hipopne indeksleri (AHİ) belirlendi. Bu işlem ameliyattan bir yıl sonra tekrarlandı. Sonuç: 57 hastaya laparoskopik sleeve gastrektomi (LSG) yapıldı. Ameliyat öncesi OUAS olan ve olmayan hastalar arasında yaş, boy, VKİ ve PMI değerleri istatistiksel olarak anlamlı derece farklıydı (P < 0.05). Ayrıca, OUAS'ı nihai olarak düzelen hastaların ameliyat öncesi ve sonrası BMI ve PMI değerlerinde istatistiksel olarak anlamlı farklılıklar tespit edildi (P < 0.05). LSG, ağırlığı azaltmak ve dolayısıyla OSAS'ı iyileştirmek için etkili bir yöntemdir. Ayrıca BMI ve PMI parametreleri OUAS'ı tahmin etmede en önemli prediktif değerlerdir. PSG, prediktif değerlere dayalı olarak seçilmiş hastalarda yapılabilir.

Keywords

• obezite
• bariatrik cerrahi
• uyku apne sendromu
• polisomnografi
• platelet kitle indexi

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