胃折叠术在肥胖治疗中的应用进展  

Application of gastric plication in the treatment of obesity

作　　者：曹冲 许博[1] 姚琪远[1] Chong Cao;Bo Xu;Qiyuan Yao(Center for Bariatric and Hernia Surgery,Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院普通外科肥胖疝外科中心,上海200040

出　　处：《中华胃肠外科杂志》2023年第11期1082-1087,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金(81970458)。

摘　　要：作为目前治疗肥胖最有效的方法,减重手术术式众多,但由于大部分的术式引起胃肠道解剖的巨大改变,使得其存在一定的并发症风险。为了追求更小的创伤,减重外科医生在经典术式之外开始探索胃折叠手术。胃折叠手术包括胃底折叠术、胃大弯折叠术、内镜下胃成形术、胃底折叠术联合胃大弯折叠术、胃底折叠术联合袖状胃切除术等多种术式,其疗效和并发症的风险介于药物治疗和袖状胃切除手术之间。胃底折叠术作为一种抗反流的术式,也可参与到减重手术治疗中,有效改善肥胖患者和减重手术相关胃食管反流病。胃大弯折叠术和内镜下胃成形术均有很好的减重效果。除了折叠术式本身对体质量的影响,胃折叠术还能与其他的术式联合。胃底折叠术联合袖状胃切除和胃大弯折叠术,可降低体质量并减少反流;胃大弯折叠术联合胃旁路等术式,也可更加有效地降低体质量,改善代谢。Bariatric surgery,as the most effective approach to treating obesity at present,encompasses a wide array of procedures.However,due to the significant anatomical changes to the gastrointestinal tract caused by most of these procedures,they are associated with certain risks of complications.In the pursuit of minimizing trauma,bariatric surgeons have begun exploring new surgeries in addition to traditional procedures.Gastric plication surgeries encompass various procedures such as gastric fundoplication,gastric greater curvature plication,endoscopic sleeve gastroplasty,combined gastric fundoplication with gastric greater curvature plication,and combined gastric fundoplication with sleeve gastrectomy,among others.The efficacy and risks of complications associated with these procedures fall between those of medical therapy and sleeve gastrectomy.Gastric fundoplication,functioning as an anti-reflux procedure,can also be integrated into weight loss surgical interventions to effectively address obesity-related gastroesophageal reflux disease in obese patients.Both gastric greater curvature plication and endoscopic sleeve gastroplasty yield favorable weight loss outcomes.Beyond the impact of folding procedures on body mass,gastric plication surgeries can also be combined with other techniques.The combination of gastric fundoplication with sleeve gastrectomy or greater curvature plication can reduce body mass and mitigate reflux,while the combination of greater curvature plication with gastric bypass and similar procedures can further enhance weight loss and metabolic improvements.

关 键 词：减重手术 胃折叠术 胃大弯折叠术 胃底折叠术 内镜下胃成形术 

分 类 号：R656.61[医药卫生—外科学]