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Improvement in Nocturnal Hypoxemia in Obese Patients with Obstructive Sleep Apnea after Bariatric Surgery: a Meta-Analysis

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Abstract

Objective

To conduct a meta-analysis examining the effects of bariatric surgery on nocturnal hypoxemia in obese patients with obstructive sleep apnea (OSA).

Methods

PubMed, EMBASE, Cochrane Library, and Web of Science were searched (the last search date was June 10, 2018) to identify relevant clinical studies. The mean arterial oxygen saturation (MeanSaO2), nadir oxygen saturation (NadirSaO2), apnea hypopnea index (AHI), and body mass index (BMI) data during the perioperative period were extracted and analyzed using a random effects model. Then, we performed subgroup and sensitivity analyses and calculated the publication bias to assess the between-study heterogeneity.

Results

In total, 15 studies with 636 patients were included; 13 were prospective observational trials, 1 was a randomized controlled trial (RCT), and 1 was a retrospective trial. After surgery, the MeanSaO2 and NadirSaO2 increased by 1.36 [95% CI (0.72, 2.00)] and 1.08 [95% CI (0.68, 1.49)], respectively, and the AHI and BMI decreased by 1.11 [95% CI (0.82, 1.40)] and 1.97 [95% CI (1.67, 2.27)], respectively. However, the heterogeneity across all trials was high; we identified some of the sources of that heterogeneity through subsequent subgroup and sensitivity analyses.

Conclusions

Bariatric surgery is effective at improving nocturnal hypoxemia in obese patients with OSA; it also reduces body weight and the number of apnea events. More randomized controlled and comparative trials are necessary in the future to confirm our findings and to explore the potential underlying mechanisms.

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Acknowledgements

Many thanks to the patience and support from my tutor, professor Wang.

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Author notes

  1. Yuxiang Zhang and Wenyue Wang contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China

    Yuxiang Zhang, Wenyue Wang, Chengcan Yang, Jiahui Shen, Meilong Shi & Bing Wang

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  1. Yuxiang Zhang
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  2. Wenyue Wang
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  3. Chengcan Yang
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  4. Jiahui Shen
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Correspondence to Bing Wang.

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Zhang, Y., Wang, W., Yang, C. et al. Improvement in Nocturnal Hypoxemia in Obese Patients with Obstructive Sleep Apnea after Bariatric Surgery: a Meta-Analysis. OBES SURG 29, 601–608 (2019). https://doi.org/10.1007/s11695-018-3573-5

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