Intensive care unit stay not required for patients with obstructive sleep apnea after laparoscopic Roux-en-Y gastric bypass

Background: Many programs admit morbidly obese patients with obstructive sleep apnea (USA) to the intensive care unit after laparoscopic gastric bypass (LGB), fearing pulmonary complications. Our practice has been to admit these patients to the surgical floor. Our objective was to compare the perioperative course and outcomes in morbidly obese patients with OSA to those of patients without USA undergoing LGB in a physician-led health system with a 325-bed community teaching hospital serving 19 counties. Methods: We retrospectively reviewed the medical records of 650 patients who had undergone LGB from 2001 to 2008 and divided them into 2 groups: patients with USA as confirmed by polysomnography (USA group) and those without OSA (non-USA group). The patients who reported a diagnosis of OSA without documentation confirming the diagnosis were excluded. The statistical analysis included t tests and chi-square tests. Results: A total of 217 patients met the inclusion criteria for the USA cohort and 368 for the non-USA cohort. Of the 650 patients, 65 reported a history of USA without confirmation and were excluded from the present study, leaving 585 patients. The demographic data were similar between the 2 groups, and no difference was found between the USA and non-USA groups for the length of postanesthesia care unit stay (105.4 versus 106.3 minutes), length of hospital stay (2.2 days for both groups), and 30-day major complication rate (3.7% versus 5.2%). No deaths and no intensive care unit admissions for pulmonary complications occurred in either group. Conclusion: The results of our study have shown that morbidly obese patients with USA undergoing LOB have a perioperative course and postoperative pulmonary complication rate similar to that of patients without USA. Thus, routine admission to the intensive care unit after LOB in patients with USA is not indicated. (Surg Obes Relat Dis 2010;6:165-170.) (C) 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved.