# Evaluation of Pulmonary Function in Long-Term Follow-Up After Laparoscopic Sleeve Gastrectomy

## TL;DR

This study shows that laparoscopic sleeve gastrectomy improves lung function in obese patients over the long term, even in smokers and those with health issues.

## Contribution

The study provides long-term evidence (minimum 10 years) of pulmonary function improvements following sleeve gastrectomy in obese patients.

## Key findings

- Significant improvements in FEV1, FEV1%, PEF, and MEF25-75 were observed after sleeve gastrectomy.
- Improvements in pulmonary function were consistent across smokers, non-smokers, and patients with or without comorbidities.
- Non-smokers showed a greater increase in FEV1 compared to smokers.

## Abstract

Obesity is one of the most important health problems in the world. It affects all systems, especially the respiratory and cardiovascular systems. Laparoscopic sleeve gastrectomy is an effective method in the treatment of obesity and can improve respiratory functions. We aimed to evaluate the effects of surgery on pulmonary function in patients with obesity.

A retrospective analysis was conducted on a group of patients who underwent sleeve gastrectomy. This study assessed pre-operative and long-term pulmonary function in patients who underwent laparoscopic sleeve gastrectomy between 2009 and 2015, with a minimum follow-up of 10 years. Patients were stratified based on smoking status and presence of comorbidities.

The study included 51 patients (82.4% female) with a mean age of 51.90 ± 11.57 years. Significant weight loss and reductions in BMI were observed postoperatively. Mean pre-operative BMI was 47.53 ± 6.95 and significantly decreased to 37.75 ± 6.02 post-operatively, BMI reduction rate was %22 (p < 0.001). Pulmonary function tests demonstrated significant improvements in FEV1 (2.65 ± 0.69 to 2.76 ± 0.67, p = 0.044), FEV1% (92.07 ± 15.31 to 97.98 ± 14.45, p = 0.001), PEF (74.01 ± 18.12 to 91.53 ± 24.16, p < 0.001), and MEF25-75 (77.17 ± 22.07 to 108.57 ± 28.11 p < 0.001) after surgery. These improvements were consistent across different subgroups, including smokers, non-smokers, and patients with and without comorbidities. Non-smokers exhibited a greater percentage increase in FEV1 compared to smokers. While there was an increase in FEV1 among patients with comorbidities, this difference was not statistically significant. Conversely, patients without comorbidities demonstrated a significant improvement in FEV1.

Bariatric surgery is associated with significant improvements in pulmonary function in obese patients, regardless of smoking status or comorbidities.