中国实用外科杂志

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术前存在胃食管反流病肥胖病人行腹腔镜胃袖状切除术的关键问题

王    勇,杨玉一   

  1. 中国医科大学第四医院普外科,辽宁沈阳 110032
  • 出版日期:2024-08-01

  • Online:2024-08-01

摘要: 肥胖是发生胃食管反流病(GERD)的危险因素,随着体重减轻,GERD也会得到改善。近年来减重代谢手术特别是腹腔镜胃袖状切除术(LSG)手术量不断增多,近期临床研究结果显示,LSG可导致GERD的新发和加重。GERD与肥胖和LSG之间关系复杂,了解潜在的病理生理学机制,根据现有证据为术前合并GERD的病人选择合理的手术方案并提供规范的LSG技术,对于预防新发GERD和改善GERD症状至关重要。

关键词: 肥胖, 胃食管反流病, 腹腔镜胃袖状切除术, Roux-en-Y胃旁路术

Abstract: Obesity is a risk factor for gastroesophageal reflux disease (GERD). As weight decreases, GERD will also improve. In recent years, the number of bariatric and metabolic surgeries, especially laparoscopic sleeve gastrectomy (LSG), has been increasing. The results of recent clinical research have shown that LSG can lead to new onset and aggravation of GERD. The relationship between GERD and obesity as well as LSG is complex. Understanding the underlying pathophysiological mechanisms, selecting a reasonable surgical plan, and providing standardized LSG techniques for patients with preoperative GERD based on existing evidence are crucial for the prevention of new-onset GERD and the improvement of GERD symptoms.

Key words: obesity, gastroesophageal reflux disease, laparoscopic sleeve gastrectomy, Roux-en-Y gastric bypass