J Metab Bariatr Surg.  2019 Jun;8(1):8-17. 10.17476/jmbs.2019.8.1.8.

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

• Ahn JH
• Bae EK
• Suh YJ
• Jeon YS
• Lee YJ
• Heo Y

• KMID: 2451782
• DOI: http://doi.org/10.17476/jmbs.2019.8.1.8

Abstract

PURPOSE
To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients.
MATERIALS AND METHODS
Patients with BMIs>27.5 kg/m2 aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS).
RESULTS
Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045-0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, <0.05 and <0.05, respectively).
CONCLUSION
Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.

Keyword

Pulmonary atelectasis; Continuous positive airway pressure; Gastric bypass; Postoperative complications; Postoperative care

MeSH Terms

Continuous Positive Airway Pressure*
Gastric Bypass*
Humans
Incidence
Length of Stay
Multivariate Analysis
Pneumonia
Postoperative Care
Postoperative Complications
Pulmonary Atelectasis*
Thorax