The Impact of Obstructive Sleep Apnea Severity on Laparoscopic Sleeve Gastrectomy Outcomes

Obstructive sleep apnea (OSA) is prevalent in patients with obesity and is a known risk factor for metabolic bariatric surgery (MBS). This study assessed the association between OSA severity and operative outcomes of laparoscopic sleeve gastrectomy (LSG) in a Japanese cohort.

We analyzed 141 patients who underwent LSG, divided into two groups based on their apnea-hypopnea index (AHI): a high-AHI group (AHI ≥ 32 events/h; n = 70) and a low-AHI group (AHI < 32 events/h; n = 71). Perioperative outcomes and gastroesophageal reflux disease (GERD) were compared. Multivariable logistic regression was used to identify independent predictors of early postoperative complications.

Patient characteristics differed significantly, with higher BMI and a higher proportion of males in the high-AHI group. CPAP was utilized by 87% of patients in the high-AHI group versus 11% in the low-AHI group. There were no significant differences between groups regarding operative time, blood loss, or GERD improvement. Multivariable analysis showed that while AHI was a statistically significant independent predictor of early complications (OR 1.018, 95% CI 1.002-1.035, p = 0.024), its clinical impact was minimal. CPAP usage showed a trend toward risk reduction (OR 0.362, p = 0.172).

Severe OSA does not prohibitively increase perioperative risk when managed with appropriate preoperative CPAP therapy.