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Bariatric surgery in patients with interstitial lung disease

机译：间质肺病患者畜牧手术

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BackgroundPerioperative pulmonary complications are frequent in patients with interstitial lung diseases (ILD). Limited literature exists regarding the safety of bariatric procedures in patients with ILD. This study aims to assess the safety, feasibility, and outcomes of patients with ILD who underwent bariatric surgery at our institution.MethodsAfter IRB approval, all patients with preoperative diagnosis of ILD who had bariatric surgery at an academic center between 2004 and 2014 were retrospectively reviewed.ResultsA total of 25 patients with ILD underwent bariatric surgery: Roux-en-Y gastric bypass (n=17, 68%), sleeve gastrectomy (n=7, 28%), and adjustable gastric banding (n=1, 4%). Twenty-one patients (84%) were females. The median age and preoperative body mass index (BMI) were 53 (IQR 42-58) years and 39 (IQR 37-44)kg/m(2), respectively. The median operative time and length of stay was 137 (IQR 110-187)min and 3 (IQR 2-5)days, respectively. The 30-day complications were reported in four patients (16%) but there was no pulmonary complication or unplanned admission to theintensive care unit. At 1-year follow-up (85%), the median BMI and excess weight loss were 30 (IQR 25-36)kg/m(2) and 67% (IQR 45-100), respectively. Compared to preoperative values, there was significant improvement in the pulmonary function test (PFT) variables at 1year with respect to forced vital capacity (62% vs 74%; n=13, p=0.003), and diffusing capacity of the lungs for carbon monoxide (53% vs 66%; n=10, p=0.003). Six out of the seven potential lung transplant candidates became eligible for transplantation after weight loss, and one of them had successful lung transplant at 88months after bariatric surgery.ConclusionIn our experience, bariatric patients with ILD achieved significant weight loss and improvement in PFT. Bariatric surgery in these higher risk ILD patients appears relatively safe with acceptable perioperative morbidity and improved candidacy for lung transplantation.
机译：背景技术肺部并发症在患有间质性肺病（ILD）的患者中经常出现。有限的文学存在关于ILD患者肥胖程序的安全性。本研究旨在评估患有ILD的ILD患者在我们的机构接受肥胖手术的安全性，可行性和结果。在2004年至2014年间，所有术前诊断的患者均术前诊断的患者在2004年至2014年之间进行了回顾审查.Resultsa共25例患者接近肥胖手术：Roux-Zh-Y胃旁路（n = 17,68％），套筒胃切除术（n = 7,28％）和可调节胃带（n = 1,4％ ）。二十一名患者（84％）是女性。中位年龄和术前体重指数（BMI）分别为53（IQR 42-58）岁和39（IQR 37-44）kg / m（2）。中位数手术时间和逗留时间为137（IQR 110-187）分钟，分别为3（IQR 2-5）天。在四名患者中报告了30天的并发症（16％），但没有肺部并发症或意外入场，对大小的护理单位。在1年后续（85％），中位数BMI和过量减肥分别为30（IQR 25-36）kg / m（2）和67％（IQR 45-100）。与术前值相比，肺功能试验（PFT）变量在1年相对于强制致动容量（62％vs 74％; n = 13，p = 0.003），以及碳的延伸能力相比一氧化物（53％vs 66％; n = 10，p = 0.003）。七种潜在的肺移植候选人中有六个患者在减肥后被遗失接种，并且在牛仔术后，其中一人在88个月后肺移植。我们的经验，患有ILD的肥胖患者患有显着的重量损失和改善PFT。在这些较高的风险中的肥胖症手术ILD患者出现相对安全的围手术期发病率和肺移植的改善候选。

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