CHEST Guidelines-Bariatric-Surgery-and-the-Risk of-Acute-Exace

Bariatric-Surgery-and-the-Risk of-Acute-Exace

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The document comprises two letters to the editor from the journal CHEST, discussing the implications of recent findings on lung and bariatric surgery. The first segment, authored by Alessandro Zanforlin, MD, and colleagues, examines the correlation between ultrasound and CT imaging in post-pneumonectomy cases, emphasizing a case where the drainage pathway was directed at the lung fissure. They urge Dr. Tinti et al. to scrutinize the discrepancies observed between ultrasound images indicating a solid/air interface, and CT scans showing fluid presence in post-pneumonectomy spaces.<br /><br />The second part is a series of correspondences about a study published by Goto et al. which investigates how bariatric surgery affects the risk of acute exacerbation in COPD. Dr. Marta Kaminska and colleagues speculate that the positive effects observed may partly be due to the alleviation of obstructive sleep apnea (OSA), a condition often linked with obesity and exacerbated COPD. They advocate for further research considering OSA's role in post-surgical COPD improvements. <br /><br />Goto and his team acknowledge this perspective in their response, indicating their reanalysis suggests bariatric surgery does indeed reduce AECOPD risk both in patients with and without OSA, albeit with a more significant impact seen in those with OSA. They surmise that bariatric surgery might mitigate the obesity-COPD relationship through the reduction of OSA severity, improved metabolic conditions, decreased systemic inflammation, and gut microbiome alterations, while also noting other non-OSA mediated factors are influential. These findings encourage further exploration of the interplay between obesity, OSA, and COPD.

Keywords

lung surgery

bariatric surgery

ultrasound imaging

CT imaging

post-pneumonectomy

obstructive sleep apnea

COPD exacerbation

obesity-COPD relationship

systemic inflammation

gut microbiome