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胃食管反流病与病态肥胖:评估与治疗

Gastroesophageal reflux disease and morbid obesity: evaluation and treatment.

作者信息

Gorodner Verónica, Viscido Germán, Signorini Franco, Obeide Lucio, Moser Federico

机构信息

Programa Unidades Bariátricas, Buenos Aires, Argentina.

Hospital Privado de Córdoba, Córdoba, Argentina.

出版信息

Updates Surg. 2018 Sep;70(3):331-337. doi: 10.1007/s13304-018-0579-4. Epub 2018 Aug 24.

Abstract

Gastroesophageal reflux disease (GERD) is markedly increased among the obese population being recognized as one of the many obesity-related comorbidities. This concept should raise awareness, making physicians investigate more profoundly about this disease in this kind of patients. Currently, bariatric surgery is considered the gold standard treatment for morbid obesity. However, not all the operations are appropriate for the treatment of GERD and not all the patients are willing to receive bariatric surgery for the treatment of GERD. Even though sleeve gastrectomy has emerged as a suitable treatment option for morbid obesity, it has been related to development of de novo GERD or worsening the pre-existing one. Conversely, results after Roux-en-Y gastric bypass have been encouraging in this aspect, and it seems to be the best option for patients who suffer both diseases. Therefore, the presence of GERD should not be ignored at the time of deciding which type of surgery will be offered to the patient.

摘要

胃食管反流病(GERD)在肥胖人群中显著增加,被认为是众多与肥胖相关的合并症之一。这一概念应提高人们的认识,促使医生更深入地调查这类患者的这种疾病。目前,减肥手术被认为是治疗病态肥胖的金标准。然而,并非所有手术都适合治疗GERD,也并非所有患者都愿意接受减肥手术来治疗GERD。尽管袖状胃切除术已成为治疗病态肥胖的合适选择,但它与新发GERD的发生或使原有GERD恶化有关。相反,Roux-en-Y胃旁路术后在这方面的结果令人鼓舞,对于同时患有这两种疾病的患者来说,它似乎是最佳选择。因此,在决定为患者提供何种类型的手术时,不应忽视GERD的存在。

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