LSG中保留胃窦部及His角完整性对术后胃食管反流病的影响  

The effect of preserving the integrity of the gastric antrum and His angle during laparoscopic gastric sleeve resection on postoperative gastroesophageal reflux disease

作　　者：孙武青 郭震 郝少龙 孙海涛[1] 姬阆 白日星 韩威[1] Wuqing Sun;Zhen Guo;Shaolong Hao;Haitao Sun;lang Ji;Rixing Bai;Wei Han(Department of General Surgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Central Laboratory,Beijing Luhe Clinical Institute,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院普外科,北京101149 [2]首都医科大学附属北京潞河医院中心实验室,北京101149

出　　处：《中华腔镜外科杂志（电子版）》2024年第2期95-99,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：北京市通州区科技计划项目(KJ2024CX039)。

摘　　要：目的探讨腹腔镜胃袖状切除术中保留胃窦部及His角完整性对术后胃食管反流病的影响。方法回顾性分析首都医科大学附属北京潞河医院2022年1月至2023年8月行腹腔镜胃袖状切除手术的肥胖症患者76例,并完成术后6个月随访的患者。分为A组40例(保留胃窦部及His角周围组织完整性)和B组36例(未保留胃窦结构及His角周围组织的完整性)。对比分析两组患者术后1、3、6个月体质量指数(body mass index,BMI)、多余体质量下降百分比(percent excess weight loss,%EWL)及胃食管反流病问卷(gastroesophageal reflux disease questionnaire,Gerd-Q)量表评分的差异性。结果A、B两组患者术前及术后6个月BMI差异无统计学意义(39.44±6.032 kg/m^(2) vs.41.74±6.677 kg/m^(2);28.99±4.763 kg/m^(2) vs.29.82±4.651 kg/m^(2),P>0.05)。A、B两组患者术前胃食管反流病(gastroesophageal reflux disease,GERD)的发病率分别是27.5%(11例)、27.8%(10例),无明显差异(P>0.05)。术后1、3、6个月时A组患者GERD的发病率(Gerd-Q评分≥8)分别是30.0%(12例)、27.5%(11例)、22.5%(9例),显著低于B组的41.7%(15例)、38.9%(14例)、36.1%(13例),P<0.05。结论保留胃窦部及His角的完整性并不影响减重效果,并且有利于降低胃袖状切除术后GERD的发病率。Objective Exploring the effect of preserving the integrity of the gastric antrum and His angle during laparoscopic gastric sleeve resection on postoperative gastroesophageal reflux disease.Methods Retrospective analysis of 76 obese patients who underwent laparoscopic gastric sleeve resection surgery at Beijing Luhe Hospital affiliated with Capital Medical University from Jan.2022 to Aug.2023,and patients who completed 6 months of postoperative follow-up.Divided into Group A with 40 cases(preserving the integrity of gastric antrum and His angle surrounding tissues)and Group B with 36 cases(not preserving the integrity of gastric antrum structure and His angle surrounding tissues).Compare and analyze the differences in body mass index(BMI),percentage excess weight loss(EWL)and GERD-Q(Gastroesophageal Reflux Disease Questionnaire)scores between two groups of patients at 1,3,and 6 months after surgery.Results There was no significant difference in BMI between the two groups of patients before and 6 months after surgery(39.44±6.032 kg/m^(2) vs.41.74±6.677 kg/m^(2);28.99±4.763 kg/m^(2) vs.29.82±4.651 kg/m^(2),P>0.05).A.The incidence rate of GERD disease before operation was 27.5%(11 cases)and 27.8%(10 cases)respectively in group B,with no significant difference(P>0.05).The incidence rate of GERD disease(Gerd-Q score≥8)in group A was 30.0%(12 cases),27.5%(11 cases),22.5%(9 cases)respectively at 1,3,and 6 months after surgery,which was significantly lower than 41.7%(15 cases),38.9%(14 cases),and 36.1%(13 cases)in group B,P<0.05.Conclusion Preserving the integrity of gastric antrum and His angle does not affect the weight loss effect,and is conducive to reducing the incidence rate of GERD after gastric sleeve resection.

关 键 词：腹腔镜胃袖状切除术 胃窦部 His角 胃食管反流病问卷(Gerd-Q) 

分 类 号：R655.4[医药卫生—外科学]