The Effect Of Bariatric Surgery On OSAHS In Obesity Patients:A Systematic Review And Meta-analysis

Objectives:1.Objectively evaluate the therapeutic of obstructive sleep apnea and hypopnea syndrome?OSAHS?in obese patients compared with lifestyle weight loss.2.Evaluate the therapetic of Roux-en-Y gastric bypass?RYGB?V.S.sleeve gastrectomy?SG?.Provide evidence-based evidence for OSAHS for obese patients undergoing weight reduction surgery.Method:Computer Retrieval Database:Googles scholar,PubMed,Embase,Clinical Key,Cochrane Library Central,Ovid,Web of Science,ClinicalTrials,China Knowledge Network,Wanfang Database,VIP Database,China Clinical Trial Registration Center;manual retrieval of our school library books To search for a high-quality clinical study take obesity and obstructive sleep apnea and hypopnea syndrome patients as object,using bariatric surgery as the main intervention,take lifestyle weight loss as control interventions,take polysomnography report as outcomes.In strict accordance with the inclusion of exclusion criteria included in the literature,the inclusion of data extraction and assessment of publication bias.Postoperative apnea-hypopnoea index?AHI?,minimum SpO₂ during sleep,sleep efficiency,and Epworth Sleepiness Scale?ESS? scores were used as objective measures for severe sleep apnea in patients.The indicators of the degree,the Body Mass Index?BMI?and the neck circumference were used to objectively evaluate the indicators among the patients,and compared with the results of diet combined exercise to lose weight.The patients in the surgical treatment group were divided into the analysis of the effect of bariatric surgery on obstructive sleep apnea and hypopnea in obeseity patients.Take sub-group analysis,quality assessment,and evaluation of risk of bias.Result:A total of 25 studies were included in 905 patients with OSAHS who were obese.The inclusion studies showed"reliable-high"quality of study with a high risk of migration.AHI:In the surgical group,the mean preoperative AHI was 39.1/h,and the AHI was reduced by 27.56/h after weight reduction surgery?95%CI[23.44,31.67]?.The AHI after RYGB was from 39.2/h decreased 29.92/h?95%CI[21.56,38.28]?,AHI decreased by 28.02/h?95%CI[11.06,44.98]?from 38.3/h before SG surgery,AHI decreased by 13.36/h?95%CI[8.17,18.54]?from 36.3/h after diet and weight loss intervention.BMI:The mean preoperative BMI was 42.7 kg/m² in the surgical group,and 18.47 kg/m²,?95%CI[13.95,22.99]?.Among them,the RYGB operation group preoperative BMI was 46.6 kg/m²,postoperatively decreased by 21.77 kg/m²?95%CI,[19.77,23.78]?,the SG operation group preoperative BMI was 52.84 kg/m²,postoperatively was decreased by 15.61 kg/m²?95%CI,[15.63,22.20]?,BMI after diet and weight loss intervention decreased by 2.64 kg/m²?95%CI[1.37,3.92]?from 36.4kg/m².Minimum Oxygen Concentration During Sleep:The minimum blood oxygen concentration during the average sleep before surgery was 76.8%in the surgical group and 9.02%in the postoperative period?95%CI[10.60,7.45]?.The lowest blood oxygen concentration during sleep after dietary exercise weight loss intervention was 82.6%,an increase of 4.01%?95%CI[7.18,0.83]?.Neck circumference:The average preoperative neck circumference in the surgical group was 44cm,postoperatively decreased by 6.39cm?95%CI[3.93,8.84]?.There were few literatures on neck circumference changes before and after dietary exercise weight loss intervention in the study report,and the stability of the results was not high.The results in this group were not meaningful.Sleep efficiency:The mean preoperative sleep efficiency in the surgical group was 75.2%,and postoperatively increased by 11.19?95%CI[16.35,6.03]?.The lowest blood oxygen concentration during sleep after diet exercise weight loss intervention was 79.2%,an increase of 2.02?95%CI[3.08,0.95]?.ESS scores:The mean preoperative ESS score was 10.7 points in the surgical group and 6.61 points in the postoperative period?95%CI[2.91,10.30]?.After diet and exercise weight loss intervention,the ESS score was 12.8 points,an increase of 3.82?95%CI[2.19,5.46]?.Conclusions:1.Both bariatric surgery and lifestyle weight loss have significant therapeutic effects on OSAHS and obesity in obese OSAHS patients.But weight loss surgery is more effective.2.RYGB has advantages compared to SG in the treatment of OSAHS and obesity.