The aim of this study was to retrospectively survey patients who had undergone the uvulopalatopharyngoplasty (UPPP) operation over a two-year period, assessing loudness of snoring, sleep quality and patient satisfaction. A total of 271 patients were sent questionnaires to assess snoring and sleeping habits, with additional questions about pain and satisfaction with surgery. Those who did not reply were contacted by telephone. Seventy-four per cent of the target population were surveyed. Taking an improvement in snoring level of 50 per cent or greater, immediately post-operatively the overall success rate was 76 per cent; however, after two years the success rate fell to 45 per cent. Variables such as alcohol consumption and smoking were not found to influence results. On a post-operative pain scale of 1–10 the average was 7.5 and on a satisfaction scale of 1–10 the average satisfaction with surgery was five, 61 per cent of patients stating that they would not have this operation again. This study shows that the UPPP operation is successful in only 45 per cent of patients after long-term follow-up, that the majority of patients experience severe pain and that the overall satisfaction with surgery is low.

The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric banding, respectively. After the laparoscopic procedure, patients had a significantly shorter stay in the post-anaesthesia care unit (0.3±0.4 and 1.1±1 days), reduced analgesic requirements, a shorter period of intravenous catheter use (2.3±1.9 and 4.8±1.4 days), were able to walk sooner (1±0.4 and 2.1±1.6 days) and had a significantly shorter duration of in-hospital stay (5.4±2.3 and 15.8±4.5 days) than after an open procedure. This report suggests that the use of laparoscopy for gastroplasty in morbidly obese patients may significantly improve the immediate post-operative course.

Oxygen consumption (̇Vo2) measured by indirect calorimetry (Nellcor-Puritan-Bennett 7250; Carlsbad, CA, USA) has been compared with ̇Vo2 calculated by the Fick method in 22 volume-controlled ventilated general surgical patients in the early post-operative period. For 198 pairs of measurements, ̇Vo2 Fick and ̇Vo2 indirect calorimetry correlated significantly (y=1.00x–35.8, P=0.0001, r=0.77). ̇Vo2 indirect calorimetry was 212±32 mL min−1 and ̇Vo2 Fick was 177±41 mL min−1 (P=0.0001). The bias was 35±26 mL min−1. This difference represents 16±13% of the total body ̇Vo2. ̇Vo2 calculated by the Fick method did not accurately predict ̇Vo2 measured by indirect calorimetry, and the two methods were not interchangeable. ̇Vo2 calculated by the Fick method underestimated ̇Vo2 as measured by indirect calorimetry by a systematic quantity that could be attributed, in part, to ̇Vo2 of the lung. Indirect calorimetry should be the preferred method for measuring total body ̇Vo2 in mechanically ventilated surgical patients.