Kendrick M L, Houghton S G
Division of Gastroenterologic and General Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. kendrick.michael.mayo.edu
Dis Esophagus. 2006;19(2):57-63. doi: 10.1111/j.1442-2050.2006.00540.x.
Gastroesophageal reflux disease (GERD) is common in obese patients. The implications of obesity in the etiology, management and outcomes in treatment for GERD have become increasingly important due to an epidemic of obesity. The increasing prevalence of patients with both obesity and GERD merits evaluation of the appropriate surgical intervention for GERD and its symptoms. With the additional advantages of weight loss and resolution of weight-related morbidity (including GERD) bariatric procedures should be the procedure of choice in patients with medically complicated obesity. Patients in lower obesity classes with body mass indices (BMI) of 30-35 kg/m2 without other substantive weight-related comorbidity should prompt consideration of both fundoplication and bariatric procedures, tailoring the best approach based on the specific patient and future implications. Patients classified as overweight but not obese (BMI < 30) are likely best treated with fundoplication; however, no randomized trials comparing fundoplication with the current antireflux bariatric procedures exist.
胃食管反流病（GERD）在肥胖患者中很常见。由于肥胖症的流行，肥胖在GERD的病因、管理和治疗结果中的影响变得越来越重要。肥胖和GERD患者的患病率不断上升，这值得对GERD及其症状的适当手术干预进行评估。由于减肥以及解决与体重相关的疾病（包括GERD）等额外优势，减重手术应成为患有医学复杂性肥胖症患者的首选手术。体重指数（BMI）为30 - 35 kg/m²、无其他实质性体重相关合并症的低肥胖等级患者，应同时考虑胃底折叠术和减重手术，并根据具体患者情况和未来影响来定制最佳方法。被归类为超重但不肥胖（BMI < 30）的患者可能最好采用胃底折叠术治疗；然而，目前尚无比较胃底折叠术与当前抗反流减重手术的随机试验。
