Palabras clave
Manejo de la obesidad
Apnea obstructiva del sueño
Síndrome de hipoventilación por obesidad
Síndrome metabólico
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Evaluar índices de apnea/hipopnea en individuos sometidos a dos técnicas de cirugía bariátrica: Manga Gástrica y Bypass Gástrico en y de Roux. Métodos: Cohorte prospectiva incluyendo pacientes obesos con Síndrome de Apnea del Sueño sometidos a cirugía bariátrica, para evaluación pre y postoperatoria mediante polisomnografía. Se midieron la masa corporal y los índices de apnea/hipopnea. Resultados: 30 participantes selecionados (60% manga gástrica). 73,3% mujeres, con edad media de 40,2 años (rango 24-63). Media de masa corporal preoperatoria y índices de apnea/hipopnea de manga gástrica y bypass gástrico fueron respectivamente 39,9 y 42,8 kg/m2, y 33,7 y 27,7 eventos/hora. Media de masa corporal postoperatoria y índices de apnea/hipopnea para manga gástrica y bypass gástrico fueron de 28,8 y 30,3 kg/m², y de 7,4 y 9,5 eventos/hora (0,3-27,3), respectivamente. No se observaron diferencias estadísticas entre los grupos en cuanto a apnea del sueño o peso. Conclusión: Ambas técnicas quirúrgicas son eficaces para controlar apnea del sueño. Pacientes con menor IMC preoperatorio fueron los principales beneficiarios. Mayor número de pacientes y estudios podría corroborar estos hallazgos.
Referencias
ARTERBURN DE, et al. Benefits and Risks of Bariatric Surgery in Adults: A Review. Journal of the American Medical Association, 2020; 324(9): 879-887.
CURRIE AC, et al. Obstructive sleep apnea remission following bariatric surgery: a national registry cohort study. Surgery for Obesity and Related Diseases, 2021; 17(9): 1576-1582.
GARG H, et al. Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study. World Journal of Gastrointestinal Endoscopy, 2017; 9(4): 162-170.
KURNOOL S, et al. Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio. Current Diabetes Reports, 2023; 23(7): 165-171.
LADOSKY W, et al. Chest mechanics in morbidly obese non-hypoventilated patients. Respiratory Medicine, 2001; 95(4): 281-286.
LI J, et al. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy to Treat Morbid Obesity-Related Comorbidities: a Systematic Review and Meta-analysis. Obesity Surgery, 2016; 26(2): 429-442.
LIN H, et al. Upper airway lengthening caused by weight increase in obstructive sleep apnea patients. Respiratory Research, 2020; 21(1): 76.
LOO GH, et al. Prevalence of obstructive sleep apnea in an Asian bariatric population: an underdiagnosed dilemma. Surgery for Obesity and Related Diseases, 2020; 16(6): 778-783.
MASHAQI S, et al. The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis. Frontiers in Sleep, 2023; 2: 1123456.
MING X, et al.. Metabolic bariatric surgery as a treatment for obstructive sleep apnea hypopnea syndrome: review of the literature and potential mechanisms. Surgery for Obesity and Related Diseases, 2021; 17(1): 215-220.
PATIL SP, KIRKNESS JP. Pathogenesis of Obstructive Sleep Apnea in Obesity. In: Sleep Apnea: Pathogenesis, Diagnosis and Treatment, 2024; 125-150.
QUINTAS-NEVES M, et al. Assessment of bariatric surgery efficacy on Obstructive Sleep Apnea (OSA). Revista Portuguesa de Pneumologia, 2016; 22(6): 331-336.
RAVESLOOT MJL, et al. Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery. European Archives of Oto-Rhino-Laryngology, 2012; 269(7): 1865-1871.
SANDS SA, et al. Pathophysiology Underlying Demographic and Obesity Determinants of Sleep Apnea Severity. Annals of the American Thoracic Society, 2023; 20(3): 440-449.
SARKHOSH K, et al. The impact of bariatric surgery on obstructive sleep apnea: a systematic review. Obesity Surgery, 2013; 23(3): 414-423.
SCHWARTZ AR, et al. Obesity and upper airway control during sleep. Journal of Applied Physiology, 2010; 108(2): 430-435.
THAHER O, et al. Outcome of Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass for Patients with Super Obesity. Obesity Surgery, 2022; 32(5): 1234-1242.
VIEGAS CAA. Epidemiologia dos distúrbios respiratórios do sono. Jornal Brasileiro de Pneumologia, 2010; 36(suppl 2): 1-3.
WARD ZJ, et al. Redrawing the US Obesity Landscape: Bias-Corrected Estimates of State-Specific Adult Obesity Prevalence. PLoS ONE, 2016; 11(3): e0150738.
WANG SH, et al. Effect of weight loss on upper airway anatomy and the apnea–hypopnea index the importance of tongue fat. American Journal of Respiratory and Critical Care Medicine, 2020; 201(6): 718-727.
WOLFE BM, et al. Treatment of Obesity: Weight Loss and Bariatric Surgery. Circulation Research, 2016; 118(11): 1844-1855.
XU C, et al. Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Obese Elder Patients: a Systematic Review and Meta-analysis. Obesity Surgery, 2020; 30(9): 3408-3416.
YAGHOUBIAN A, et al. Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Achieve Comparable Weight Loss at 1 Year. The American Surgeon, 2012; 78(12): 1325-1328.
YOUNG T, et al. Excess weight and sleep-disordered breathing. Journal of Applied Physiology, 2005; 99(4): 1592-1599.
YOUNG T, et al. Risk factors for obstructive sleep apnea in adults. Journal of the American Medical Association, 2004; 291(16): 2013-2016.