Melissas John, Braghetto Italo, Molina Juan Carlos, Silecchia Gianfranco, Iossa Angelo, Iannelli Antonio, Foletto Mirto
Bariatric Unit, Heraklion University Hospital, University of Crete, 164 Erythreas Street, 714 09, Heraklion, Crete, Greece.
Department of Surgery, Hospital Clínico "Dr Jose J. Aguirre", Faculty of Medicine, University of Chile, Santiago, Chile.
Obes Surg. 2015 Dec;25(12):2430-5. doi: 10.1007/s11695-015-1906-1.
Gastroesophageal reflux disease (GERD) and/or hiatus hernia (HH) are one of the most common disorders of the upper gastrointestinal tract. Despite the positive effect of sleeve gastrectomy (SG) regarding weight loss and improvement in obesity co-morbidities, there are concerns about the development of de novo gastroesophageal reflux disease or worsening the existing GERD after this bariatric operation. Furthermore, controversy exists on the consequences of SG in lower esophageal sphincter function and about the ideal procedure when a hiatus hernia is preoperatively diagnosed or discovered during the laparoscopic SG. This review systematically investigates the incidence, the pathophysiology of GERD and/or HH in morbidly obese individuals before and after SG, and the treatment options for concomitant HH repair during laparoscopic sleeve gastrectomy.
胃食管反流病（GERD）和/或食管裂孔疝（HH）是上消化道最常见的疾病之一。尽管袖状胃切除术（SG）在减重和改善肥胖相关合并症方面有积极作用，但人们担心在这种减肥手术后会新发胃食管反流病或使现有GERD病情恶化。此外，关于SG对食管下括约肌功能的影响以及术前诊断出食管裂孔疝或在腹腔镜SG过程中发现食管裂孔疝时的理想手术方式存在争议。本综述系统地研究了病态肥胖个体在SG前后GERD和/或HH的发病率、病理生理学，以及腹腔镜袖状胃切除术中同时进行HH修复的治疗选择。
