新型抗反流袖状胃切除术与袖状胃切除联合食管裂孔疝修补术的临床疗效对比  

Comparison of clinical efficacy between a novel antireflux sleeve gastrectomy and sleeve gastrectomy combined with esophageal hiatal hernia repair surgery

作　　者：艾克拜尔·艾力[1,2,3] 崔剑昱 皮尔地瓦斯·麦麦提玉素甫 麦麦提艾力·麦麦提明[1,2,3] 黎鑫 玉素江·图荪托合提 王浩 克力木·阿不都热依木 Aikebaier-Aili;Cui Jianyu;Pierdiwasi-Maimaitiyusufu;Maimaitiaili-Maimiatiming;LiXin;Yusujiang-Tusuntuoheti;Wang Hao;Kelimu'Abudureyimu(Department of Minimally Invasive Surgery,Hernia and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery,Research Institute of General and Minimally Invasive Surgery,Urumqi 830002,China;Xinjiang Uygur Autonomous Region,Xinjiang Medical University,Urumqi 830002,China;Xinjiang Medical University Graduate School of Medicine,Urumqi830054,China)

机构地区：[1]新疆维吾尔自治区人民医院微创、疝和腹壁外科,乌鲁木齐830001 [2]新疆胃食管反流病与减重代谢外科临床医学研究中心,乌鲁木齐830002 [3]新疆维吾尔自治区普外微创研究所,乌鲁木齐830002 [4]新疆医科大学研究生学院,乌鲁木齐830054

出　　处：《中华普通外科杂志》2024年第6期450-455,共6页Chinese Journal of General Surgery

摘　　要：目的评价新型抗反流袖状胃切除术(LSGFD)与腹腔镜袖状胃切除术联合食管裂孔疝修补术(LSG+HHR)治疗肥胖合并胃食管反流病(GERD)的疗效.方法回顾性分析2020年1月至2022年1月新疆维吾尔自治区人民医院收治的73例肥胖合并GERD患者,其中41例行LSGFD术,32例行LSG+HHR,收集并比较患者术前及术后1年的GERD调查问卷评分表(Gerd-Q)、测酸测压等相关临床资料的差异.结果两组患者术后BMI较术前均有明显降低,差异有统计学意义(P<0.05);两组术后BMI下降百分比差异无统计学意义(P>0.05).两组术后Gerd-Q评分、酸反流分析和食管动力学分析较术前差异有统计学意义(P<0.05),术后LSGFD的DeMeester评分较LSG+HHR术后下降明显,差异有统计学意义(P<0.05);两组术中出血量、住院时间和手术时长差异无统计学意义(P>0.05).LSGFD组出院后并发症(恶心或呕吐、贫血)发生率和GERD复发率差异无统计学意义(P>0.05).结论LSGFD在治疗肥胖合并GERD方面较LSG+HHR疗效更好.Objective To evaluate a novel anti-reflux sleeve gastrectomy(LSGFD)in comparison with laparoscopic sleeve gastrectomy combined with hiatal hernia repair(LSG+HHR)for the treatment of obesity-combined gastroesophageal reflux disease(GERD).Method Seventy-three patients admitted at Xinjiang Uygur Autonomous Region People's Hospital from Jan 2020 to Jan 2022 underwent LSGFD(41 cases)or LSG+HHR(32 cases),and the patients'preoperative and 1-year postoperative GERD questionnaire scores(Gerd-Q),acidometry and manometry and other relevant clinical data were collected and compared.Results The postoperative BMI of the two groups was significantly lower than that of the preoperative period,and the difference was statistically significant(P<0.05);the comparison of the percentage of postoperative body mass loss between the two groups was not statistically significant(P>0.05).Differences in postoperative Gerd-Q score,acid reflux analysis and esophageal dynamics analysis of the two groups were statistically significant compared with the preoperative period(P<0.05),DeMeester score of LSGFD decreased significantly compared with that of LSG+HHR(P<0.05).There was no significant difference in intraoperative blood loss,hospitalization time and duration of the operation between the two groups(P>0.05)The incidence of post-discharge complications(nausea or vomiting,anemia)and the recurrence rate of GERD were lower in the LSGFD group,though there was no statistically significant difference(P>0.05).Conclusion LSGFD is better than LSG+HHR in treating obesity combined with GERD.

关 键 词：肥胖症 胃食管反流 胃切除术 疝 食管裂孔 胃底折叠术 

分 类 号：R656.61[医药卫生—外科学]