Laparoscopic Sleeve Gastrectomy: A Single Egyptian Center Experience with Anesthetic and Surgical Complications

Introduction: Laparoscopic sleeve gastrectomy (LSG) as bariatric operation is gaining popularity nowadays. Many studies reported patient surgical outcome after LSG, however little is known about perioperative anesthesia-related complications. In this study we are reporting our experience in an university hospital with perioperative complications and adverse events in morbidly obese patients undergoing LSG.

Methods: A prospective cohort study was conducted in Cairo university hospitals. All patients scheduled for LSG during a period of seven months were included. Anesthesia-related complications were reported as well as surgical outcomes. Major anesthesia complications were defined as: intraoperative or postoperative cardiac arrest, failed intubation, postoperative ventilation, and postoperative inotropic support. Possible risk factors for developing perioperative complications were also analyzed using univariate and multivariate analysis.

Results: One hundred and fifty patients were included. Mean age was 33±6 years and mean Body mass index (BMI) was 48±6. No major anesthesia related complications were reported. We reported three cases (2%) of surgical anastomotic leakage and four cases (2.6%) of difficult intubation. Regarding minor complications, the most common were intraoperative and postoperative tachycardia (75%), increased plateau airway pressure (75%), and postoperative nausea and vomiting (60%). By multivariate analysis; independent risk factors for respiratory complications are BMI above 50 and STOP-BANG questionnaire score.

Conclusion: LSG is done in our center with a low rate of major anesthesia-related complications. Difficult intubation is not common in morbid obese patients. Risk factors for pulmonary complications in this population were BMI above 50 and STOP-BANG questionnaire.