title: Laparoscopic versus open obesity surgery: a meta-analysis of pulmonary complications.
abstract: The clinical effects of laparoscopy in the pulmonary function of obese patients have been poorly investigated in the past. A systematic review was undertaken, with the objective to identify published evidence on pulmonary complications in laparoscopic surgery in the obese. Outcome measures included pulmonary morbidity, pulmonary infection and mortality. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) with 95% confidence interval (CI). A total of 6 randomized and 14 observational studies were included, which reported data on 185,328 patients. Pulmonary complications occurred in 1.6% of laparoscopic and in 3.6% of open procedures (OR 0.45, 95% CI 0.34-0.60). Pneumonia was reported in 0.5% and in 1.1%, respectively (OR 0.45, 95% CI 0.40-0.51). Available evidence suggests lower pulmonary morbidity for laparoscopic surgery in obese patients; further quality studies are however necessary to consolidate these findings.
authors.affiliation: Center for Minimally Invasive Surgery, Hospital Neuwerk, Mönchengladbach, Germany.
authors.forename: Stavros Athanasios
authors.initials: SA
authors.lastname: Antoniou
authors.forename: George Athanasios
authors.initials: GA
authors.lastname: Antoniou
authors.forename: Oliver Owen
authors.initials: OO
authors.lastname: Koch
authors.forename: Gernot
authors.initials: G
authors.lastname: Köhler
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
authors.forename: Frank-Alexander
authors.initials: FA
authors.lastname: Granderath
mesh_terms: D050110:Bariatric Surgery / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology*; D015233:Models, Statistical; D009765:Obesity / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome