Georgia Doulami, Stamatina Triantafyllou, Maria Natoudi, Konstantinos Albanopoulos, Konstantinos Filis, Emmanouil Leandros, Georgios Zografos, Dimitrios Theodorou
Foregut Department, 1st Propaedeutic Surgical Department, Hippokration General Hospital of Athens, National and Kapodistrian University of Athens, 114 Vas Sofias Av, 115 27, Athens, Greece.
Bariatric Surgery Department, 1st Propaedeutic Surgical Department, Hippokration General Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece.
Obes Surg. 2017 Mar;27(3):749-753. doi: 10.1007/s11695-016-2359-x.
It is not yet clear if laparoscopic sleeve gastrectomy (LSG) causes newly onset gastroesophageal reflux (GERD) or worsens already existing GERD. This is due to the absence of prospective studies using objective assessment measures of GERD such as pH monitoring. Our study aims at assessing GERD 1-year post-LSG procedure for obesity.
Twelve asymptomatic obese patients were studied prospectively by using 24-h multichannel intraluminal impedance-pHmetry (MIIpH) pre- and 12 months post-LSG.
Of patients' 1-year post-LSG, 83.33 % of patients' suffer from GERD (either newly onset or worsening of already existing) as indicated by abnormal DeMeester score. Mean DeMeester score 1-year post LSG was 47, almost 2.5 times higher than the preoperative score (p = 0.072). The percentage of total time with pH lower than four was statistically significant higher postoperatively (13.27 % vs 3.87 %, p = 0.048).
This study is one of the few assessing GERD post-LSG by using 24-h MIIpH. The majority of patients suffer from GERD 12 months postoperatively, implying that close postoperative monitor for GERD with the use of pH testing and upper gastrointestinal endoscopy in order to early diagnose GERD and identify possible mucosal injury and also a prophylactic proton pump inhibitor use may be of great importance.
目前尚不清楚腹腔镜袖状胃切除术（LSG）是否会引发新的胃食管反流病（GERD）或使已有的GERD病情恶化。这是因为缺乏使用诸如pH监测等GERD客观评估指标的前瞻性研究。我们的研究旨在评估肥胖患者接受LSG手术后1年的GERD情况。
对12例无症状肥胖患者进行前瞻性研究，在LSG术前和术后12个月使用24小时多通道腔内阻抗-pH监测（MIIpH）。
LSG术后1年，根据异常的DeMeester评分显示，83.33%的患者患有GERD（无论是新发还是已有病情恶化）。LSG术后1年的平均DeMeester评分为47，几乎是术前评分的2.5倍（p = 0.072）。术后pH值低于4的总时间百分比在统计学上显著高于术前（13.27%对3.87%，p = 0.048）。
本研究是少数几项通过24小时MIIpH评估LSG术后GERD的研究之一。大多数患者在术后12个月患有GERD，这意味着术后使用pH检测和上消化道内镜密切监测GERD，以便早期诊断GERD并识别可能的黏膜损伤，同时预防性使用质子泵抑制剂可能非常重要。
