• M Scheuller and D Weider.
• Department of Otolaryngology, University of California San Francisco, 400 Parnassus Ave., San Francisco, CA 04122-2721, USA. nephi@alum.dartmouth.org
• Otolaryngol Head Neck Surg. 2001 Oct 1; 125 (4): 299-302.

ObjectiveTo evaluate the long-term outcomes of bariatric surgery with respect to respiratory disturbance index (RDI) in sleep apnea syndrome (SAS).DesignCase series with long-term follow-up (1 to 12 years).SettingPrivate clinic in an academic tertiary referral center.PatientsFifteen morbidly obese patients (10 men, 5 women) who were referred for the treatment of severe SAS.InterventionFor all 15 patients who presented with severe SAS, nasal positive airway pressure breathing was either not available or was not tolerated by the patient; therefore, bariatric surgery was performed as a means of treatment for SAS.Main Outcome MeasuresRDIs and minimum oxygen saturation were measured both preoperatively and postoperatively (1 to 12 years after surgery).ResultsWeight loss ranged from 60 to 220 pounds (27 to 100 kg). RDI decreased by at least 55% in each patient, and all patients with tracheostomies (8 of 15) had their tracheostomy tubes removed. Average RDI preoperatively was 96.9 and average RDI postoperatively was 11.3. Results were similar for all 15 patients in that minimum oxygen saturation increased during sleep from an average preoperative minimum oxygen saturation of 58.7% to an average postoperative minimum oxygen saturation of 85.2%.ConclusionsBariatric surgery as a means of treating SAS in the morbidly obese provides effective long-term reduction in RDI. Bariatric surgery also significantly improves minimum oxygen saturation in morbidly obese patients with SAS. Biliopancreatic bypass is more effective in reducing RDI to normal values than vertical banded gastroplasty.

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