Abstract: Meta analysis of the efficacy of sleeve gastrectomy combined with esophageal hiatal hernia repair in the treatment of obesity complicated with gastroesophageal reflux disease        LI Zan-lin*，Saimi·Saimaiti ，LI Yi-liang，et al. *Department of Minimally Invasive Surgery，Hernia and Abdominal Wall Surgery，People's Hospital of Xinjiang Uygur Autonomous Region，Urumqi 830001，China
Corresponding author：Kelimu·Abudureyimu，E-mail：klm6075@163.com
Abstract    Objective    To evaluate the efficacy of laparoscopic sleeve gastrectomy combined with esophageal hiatal herniorrhaphy (LSG+HHR) in the treatment of obesity complicated with gastroesophageal reflux disease（GERD）. Methods    The databases of PubMed，EMbase，The Cochrane Library，Wanfang and CNKI were searched by computer，and the literatures were screened according to the inclusion criteria and exclusion criteria. The relevant data were extracted，and the methodological quality evaluation and Meta analysis were carried out. Results    A total of 9 articles and 499 patients were included. The results of Meta analysis showed that there was significant difference in the changes of BMI before and after LSG+HHR operation（MD=11.92，95%CI 12.68-13.15，P＜0.001）. The weight loss of patients after LSG+HHR was more obvious than that before operation. There was significant difference in GERD symptoms before and after LSG+HHR operation（OR=3.35，95%CI 1.15-9.75，P=0.03）. GERD symptoms were significantly relieved after LSG+HHR，GERD symptom remission rate after LSG+HHR operation was significantly different（OR=0.53，95%CI 0.19-0.87，P=0.002），and GERD symptom remission rate after LSG+HHR was obvious. Conclusion    LSG+HHR can improve GERD，and prevent the occurrence of new GERD symptoms in asymptomatic patients. The remission rate of GERD symptoms is significantly increased after operation.

Key words: laparoscopic sleeve gastrectomy, esophageal hiatal herniorrhaphy, obesity, gastroesophageal reflux disease (GERD), Meta analysis

摘要： 目的    评价腹腔镜胃袖状切除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    计算机检索PubMed、EMbase、The Cochrane Library、万方数据、中国知网等数据库，按照纳入标准和排除标准筛选文献，提取纳入文献的相关数据，并对其进行方法学质量评价和Meta分析。结果    共纳入9篇文献、499例病人。Meta分析结果显示，LSG+HHR手术前后BMI（MD=11.92，95%CI 12.68～13.15，P<0.001）、GERD症状（OR=3.35，95%CI 1.15～9.75，P=0.03）以及术后GERD症状缓解率（OR=0.53，95%CI 0.19～0.87，P=0.002）比较差异有统计学意义。结论    LSG+HHR可改善GERD病症，也可预防无症状病人中新GERD症状的出现，术后GERD症状缓解提高明显。

关键词: 腹腔镜胃袖状切除术, 食管裂孔疝修补术, 肥胖, 胃食管反流病, Meta 分析