Iovino P, Angrisani L, Tremolaterra F, Nirchio E, Ciannella M, Borrelli V, Sabbatini F, Mazzacca G, Ciacci C
Dipartimento di Chirurgia Generale, Geriatrica, Oncologica e Tecnologic Avanzate e, Università Federico II, Napoli, Italy.
Surg Endosc. 2002 Nov;16(11):1631-5. doi: 10.1007/s00464-001-9225-0. Epub 2002 Jun 20.
The relation between gastro-esophageal reflux disease (GERD) and obesity is controversial. The laparoscopic adjustable gastric band (LAGB) procedure is effective for morbid obesity. Its indication in the presence of GERD, however, is still debated. This study aimed to investigate esophageal symptoms, motility patterns, and acid exposure in morbidly obese patients before and after LAGB placement.
For this study, 43 consecutive obese patients were investigated by a standardized symptoms questionnaire, stationary manometry and 24-h ambulatory pH-metry, and 16 patients with abnormal esophageal acid exposure were reevaluated 18 months after LAGB placement.
Symptom scores and abnormal esophageal acid exposure were found to be significantly higher, Lower Esophageal Sphincter (LOS) pressure was significantly lower in obese patients than in control subjects. After LAGB, esophageal acid exposure was significantly reduced in all but two patients, who presented with proximal of gastric pouch dilation.
There is a high prevalence of GERD in the obese population. Uncomplicated LAGB placement reduces the amount of acid in these patients with abnormal esophageal acid exposure.
胃食管反流病（GERD）与肥胖之间的关系存在争议。腹腔镜可调节胃束带术（LAGB）对病态肥胖有效。然而，其在GERD患者中的应用指征仍存在争议。本研究旨在调查病态肥胖患者在LAGB植入前后的食管症状、动力模式和酸暴露情况。
本研究中，连续43例肥胖患者接受了标准化症状问卷、静态测压和24小时动态pH监测，16例食管酸暴露异常的患者在LAGB植入18个月后进行了重新评估。
发现肥胖患者的症状评分和食管酸暴露异常显著更高，下食管括约肌（LOS）压力显著低于对照组。LAGB术后，除两名胃囊近端扩张的患者外，所有患者的食管酸暴露均显著降低。
肥胖人群中GERD的患病率很高。单纯LAGB植入可减少这些食管酸暴露异常患者的胃酸量。
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