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腹腔镜胃袖状切除术对胃食管反流病的影响 被引量:5

The effect of laparoscopic sleeve gastrectomy on gastroesophageal reflux disease
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摘要 目的:探讨肥胖患者胃食管反流病(gastroesophageal reflux disease,GERD)情况及腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)对GERD的影响。方法:2015年11月至2016年10月113例肥胖患者接受LSG,其中男21例,女92例;平均(30±8)岁。采用反流性疾病问卷(reflux diagnostic questionnaire,RDQ)进行评估,评分≥12则诊断为GERD。结果:术前符合GERD的患者共12例,患病率为10.6%(12/113)。随访12个月,9例RDQ评分<12分,缓解率为75%(9/12)。LSG术后GERD新发率为29.7%(30/101),其中66.7%(20/30)口服质子泵抑制剂治疗,50%(10/20)症状可缓解;未服用药物者,90%(9/10)症状明显改善。LSG术后12个月,新发GERD率为10.9%(11/101)。结论:肥胖患者GERD患病率显著增高,行LSG术后症状多可明显改善。LSG术后有新发GERD的风险,患者症状多可有效缓解,但仍有少部分持续存在。 Objective: To investigate the prevalence of gastroesophageal reflux disease( GERD) in obese patients and the effect of laparoscopic sleeve gastrectomy( LSG) on GERD. Methods: A total of 113 patients underwent LSG from Nov. 2015 to Oct. 2016,there were 21 men and 92 women with a mean age of( 30 ± 8). All patients were followed up for 12 months after LSG. The perioperative and postoperative GERD symptoms were evaluated using reflux diagnostic questionnaire( RDQ),and GERD diagnosis was considered positive if RDQ ≥ 12. Results: Twelve patients were diagnosed with GERD( 10. 6%) preoperatively. The remission rate was 75%( 9/12) with 9 patients' RDQ 12 postoperatively. 30 patients( 29. 7%) showed new-onset GERD after LSG,of which 20 were treated with proton pump inhibitor and 10 remitted. 90%( 9/10) of new-onset GERD patients without medicine therapy had the alleviation.10. 9%( 11/101) patients met the diagnostic criteria of new-onset GERD 12 months after LSG. Conclusions: The prevalence of GERD is markedly increased in the obese patients,and symptoms of GERD can be significantly improved after LSG. The risk of new-onset GERD exists after LSG and can be remitted effectively,yet a minority of patients with new-onset GERD may suffer from persisted symptoms.
作者 曹东亮 朱江帆 马颖璋 马驰野 郭海军 汪运节 CAO Dong-liang, ZHU Jiang-fan, MA Ying- zhang, et al.(Department of Diabetes and Bariatric Surgery, East Hospital of Tongji University School of Medicine, Shanghai 200120, Chin)
出处 《腹腔镜外科杂志》 2018年第1期17-20,共4页 Journal of Laparoscopic Surgery
关键词 胃食管反流 肥胖症 袖状胃切除术 腹腔镜检查 Gastroesophageal reflux Obesity Sleeve gastrectomy Laparoscopy
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