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Ten (33%) were still using CPAP postoperatively (Table?1), of whom, one (10%) had had a gastric band, one (10%) a gastric balloon, and 8 (80%) a Roux-on-y gastric bypass. There were 20 patients in the non-CPAP group, two gastric bands (10%) and 18 gastric bypasses (90%). Three (10%) patients had been given advice regarding cessation of CPAP therapy pre-operatively, and nine (30%) were followed up postoperatively by the sleep clinic. In our audit, one-third of patients�� symptoms did not resolve adequately to enable them http://www.selleckchem.com/products/MDV3100.html to stop CPAP use. Most patients (if they were able to stop using CPAP) did so in the first 6?months postoperatively. We have demonstrated that CPAP may be needed long term after bariatric surgery, and we should advise patients better pre-operatively regarding CPAP use postoperatively. Sleep clinic follow-up is not uniform, and may better quantify the need for ongoing CPAP. 1.Lettieri CJ, Eliasson AH, Greenburg DL. Persistence of obstructive sleep apnoea after surgical weight loss. Journal of Clinical Sleep Medicine 2008; 4: 333�C8. 2.Varela JE, Hinojosa MW, Nguyen NT. Resolution of obstructive sleep apnoea after laparoscopic gastric bypass. Obesity Surgery 2007; 17: 1279�C82. H. Kaskos, L. Peltola and M. D. Esler Imperial College Healthcare NHS Trust and Queen Charlotte��s Hospital, London, UK Email: hkaskos@doctors.org.uk We assessed the safety of ward-based postoperative care of morbidly obese gynaecology patients. We reviewed their peri-operative http://www.selleck.cn/products/pd-1-pd-l1-inhibitor-2.html management to evaluate the incidence of comorbidities, difficult airways, use of invasive monitoring and postoperative complications. Following ethics approval, cases for this retrospective cohort study were identified from the hospital database (2004�C2010). All gynaecology patients with a body mass index (BMI) ��?40?kg.m?2, on a single surgical consultant��s operating list having total laparoscopic hysterectomy, were identified and the casenotes reviewed. Twenty-seven patients were included, with a mean (SD) BMI of 47.6 (5.8) kg.m?2; age 63 (12) years; and ASA status 2 (1). Cardiovascular disease was the most common comorbidity in 21 (78%) patients, followed by diabetes in 12 (44%). Six (22%) had obstructive airway disease and one (4%) was a snorer. Two patients (8%) were described as having a difficult airway, and invasive monitoring was used in nine http://www.selleckchem.com/products/gsk1120212-jtp-74057.html (33%) patients. Fifteen (56%) received only short acting opioids and 14 (52%) required no opioids in recovery. Only 12 (44%) required opioids in the first 24?h postoperatively. Twenty-five (93%) patients were admitted to the ward postoperatively. One (4%) patient (190?kg) was electively admitted to the ICU and one (4%) was an unplanned admission from recovery for hypoxia that required noninvasive ventilation. Both were discharged from the ICU within 24?h. On the ward, hypoxia (SpO2?