High altitude as a prognostic factor in sleeve gastrectomy outcomes: A systematic review and meta-analysis

Sleeve gastrectomy is a widely performed bariatric surgery, yet its outcomes can vary significantly depending on environmental factors such as high altitude. High altitude, characterized by hypobaric hypoxia, may affect oxygen delivery, recovery, and metabolic processes post-surgery. This study aims to evaluate high altitude as a prognostic factor in sleeve gastrectomy outcomes, focusing on complication rates, weight loss, and recovery duration.

The meta-analysis revealed a significantly higher postoperative complication rate for the high-altitude group, with a relative risk (RR) of 1.45 (95 % CI: 1.35-1.55, p < 0.05) [9, 14]. To address heterogeneity in altitude definitions [6, 9], we performed a sensitivity analysis excluding the study with the highest altitude cutoff (≥2500 m). The results remained consistent (RR: 1.42, 95 % CI: 1.32-1.53) [14, 19], confirming the robustness of our primary finding.

High altitude is a critical factor influencing sleeve gastrectomy outcomes, leading to increased complications and prolonged recovery. Preoperative assessments and postoperative care must address altitude-specific challenges, including enhanced oxygenation strategies, to optimize patient recovery and surgical success. These findings emphasize the need for tailored clinical approaches to improve outcomes for bariatric surgery patients in high-altitude environments.