Perioperative Respiratory Function in Sleeve Gastrectomy

NCT07629102 | Completed

• 1 other identifier: 2026-134
• Study Type: interventional
• Target: 53
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective single-center cohort study aims to evaluate the effects of two intraoperative ventilation strategies on perioperative oxygenation and respiratory outcomes in obese patients undergoing laparoscopic sleeve gastrectomy. Patients were managed using standardized anesthetic and ventilatory protocols with volume-controlled ventilation and fixed inspired oxygen fraction (FiO₂ 45%). The study compares conventional ventilation with PEEP 5 cmH₂O versus a protective ventilation strategy consisting of PEEP 8 cmH₂O combined with repeated recruitment maneuvers performed after pneumoperitoneum establishment and before extubation. Perioperative oxygenation is assessed using serial PaO₂/FiO₂ measurements obtained immediately after intubation, after pneumoperitoneum establishment, and after extubation. Secondary outcomes include perioperative arterial blood gas variables, postoperative spirometric parameters, lactate levels, ICU admission, and hospital length of stay. The study aims to determine whether escalation of intraoperative ventilatory support provides incremental respiratory benefit in contemporary bariatric anesthesia practice.

Conditions

Obesity (BMI > 35); Sleeve Gastrectomy; Oxygenation; Peep Titration in Lung Protective Ventilation

Keywords

Obesity; laparoscopic sleeve gastrectomy; PEEP titration; perioperative oxygenation

Outcome Measures

Primary Outcomes (1)

• PaO2/FiO2 ratio

  The primary outcome of the study was perioperative oxygenation assessed by serial PaO2/FiO2 ratio measurements.

  T0: immediately after endotracheal intubation • T1: 10 minutes after establishment of pneumoperitoneum and achievement of the target intra-abdominal pressure • T2: 5 minutes afte

Secondary Outcomes (4)

• Postoperative pulmonary function tests

  Were evaluated before the surgery and on the day of hospital discharge

• Intensive care unit admission

  Postoperative day 0

• PaCO₂, pH, oxygen saturation

  T0: immediately after endotracheal intubation • T1: 10 minutes after establishment of pneumoperitoneum and achievement of the target intra-abdominal pressure • T2: 5 minutes afte

• Hospital length of stay

  On which day the patients were discharged

Study Arms (2)

PEEP 5/no recruitment maneuver

OTHER

Patients were ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH₂O without recruitment maneuvers

Other: PEEP 5 cmH2O

PEEP 8/recruitment maneuver

OTHER

Patients received a protective ventilation strategy consisting of PEEP 8 cmH₂O combined with repeated recruitment maneuvers performed after pneumoperitoneum insufflation and before extubation

Other: PEEP 8 cmH2O + Recruitment Maneuvers

Interventions

PEEP 8 cmH2O + Recruitment Maneuvers OTHER

Recruitment maneuvers were performed using a stepwise PEEP increase strategy. PEEP levels were gradually increased over consecutive respiratory cycles up to 15-20 cmH₂O and subsequently reduced to the assigned maintenance PEEP level.

PEEP 8/recruitment maneuver

PEEP 5 cmH2O OTHER

Patients were ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH₂O without recruitment maneuvers

PEEP 5/no recruitment maneuver

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- American Society of Anesthesiologists (ASA) physical status I-III who underwent elective laparoscopic sleeve gastrectomy

You may not qualify if:

• revision bariatric surgery
• gastric bypass surgery
• conversion to open surgery
• incomplete perioperative records
• missing arterial blood gas measurements
• unavailable postoperative pulmonary function tests

Sponsors & Collaborators

• Istanbul Saglik Bilimleri University: lead

Study Sites (1)

Basaksehir Cam and Sakura City Hospital

Istanbul, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Obesity

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Masking Details: The study was conducted retrospectively.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associated professor

Study Record Dates

• First Submitted: May 22, 2026
• First Posted: June 5, 2026
• Study Start: April 1, 2026
• Primary Completion: April 15, 2026
• Study Completion: May 20, 2026
• Last Updated: June 5, 2026

Record last verified: 2026-05

Locations

TU (1)