The Risk of Pulmonary Aspiration in Patients After Weight Loss Due to Bariatric Surgery

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In Brief BACKGROUND: We conducted a study including patients with gastric banding or gastroplasty who previously underwent plastic or functional surgery to assess the risk of pulmonary aspiration. METHODS: A retrospective case–control study was performed including all patients undergoing a plastic or functional surgery over a 5-yr period (2000–2005) at Rouen University Hospital. Two groups were defined: the postbariatric group included patients who previously had bariatric surgery (laparoscopic adjustable gastric banding or Mason’s vertical gastroplasty) before undergoing the plastic surgery; all other patients were assigned to the control group. Data included all anesthetic management and were recorded in the hospital computer database. The incidence of pulmonary aspiration was the outcome variable. RESULTS: One hundred ninety-eight plastic and functional operations (66 cases and 132 controls) were performed. Pulmonary aspiration was significantly (P < 0.006) higher in the postbariatric group (4 patients: 6%) than in the nonbariatric group (0 patient). For this complication, all patients had previously undergone gastric banding. One patient who did not receive prokinetic prophylaxis required intensive care for severe pulmonary alteration. CONCLUSION: The risk of perioperative pulmonary aspiration in a patient after weight loss due to gastric banding was considered significant. IMPLICATIONS: We conducted a retrospective case–control study of 198 plastic and functional operations (66 postbariatric patients and 132 nonbariatric patients). Pulmonary aspiration was significantly (P < 0.006) more frequent in postbariatric group (4 patients: 6%) than in the nonbariatric group (0 patient). For this complication, all the patients had previous gastric banding. We conclude that the risk of perioperative pulmonary aspiration after weight loss due to bariatric surgery is very significant.