关键词: 减重代谢手术, 腹腔镜胃袖状切除术, 袖状胃胸腔内上移, 肥胖症

Abstract: Intra-thoracic sleeve migration (ITSM) is a potential complication after laparoscopic sleeve gastrectomy (LSG) and is related to central obesity, gastroesophageal reflux disease, surgical procedures, postoperative weight loss, and other factors. The auxiliary diagnosis can be done by computed tomography (CT), esophagogastroduodenoscopy, upper gastrointestinal imaging, and other related examinations. Repairing esophageal hiatus hernia during LSG is the key to preventing ITSM. Acute ITSM is prone to cause serious consequences such as incarceration, requiring rapid intervention, while long-term ITSM after surgery affects the quality of life and also requires surgical intervention. For patients with a high risk of recurrences, such as large hiatal hernia (HH)  defects and gastric stenosis, if there are no contraindications to Roux-en-Y gastric bypass (RYGB) when they can accept the risk of surgery, modifying it to RYGB is recommended, and combining with other surgeries to reduce the risk of recurrence.

Key words: bariatric and metabolic surgery, laparoscopic sleeve gastrectomy, intra-thoracic sleeve migration, obesity