胃袖套切除术后重度反流的 LINX 系统腹腔镜置管治疗。
Laparoscopic placement of the LINX system in management of severe reflux after sleeve gastrectomy.
机构信息
St. John Hospital and Medical Center, Detroit, MI, USA.
St. John Hospital and Medical Center, Detroit, MI, USA.
出版信息
Am J Surg. 2019 Mar;217(3):496-499. doi: 10.1016/j.amjsurg.2018.10.040. Epub 2018 Oct 29.
BACKGROUND
Management of severe reflux after sleeve gastrectomy (SG) is often done by conversion to Roux-en-Y gastric bypass (RYGB). The LINX system could be an alternative treatment.
METHOD
Between 2015 and 2017, 13 patients had LINX system placed to manage their reflux after SG. Pre-operative evaluation included a barium swallow, endoscopy with pH monitor and esophageal motility.
RESULTS
Ten females and three males with mean age of 49 ± 13 years were evaluated. Their mean weight before placing the LINX system was 193 ± 45 lbs. and mean BMI of 33 ± 6 kg/m. The mean time between SG and placing the LINX system was 43 ± 19 months. The mean Bravo score was 46 ± 26 (normal 14.7). One patient developed severe dysphagia post-operatively requiring removal of the LINX after 18 days and one patient was lost to follow up. The mean follow-up in the remaining 11 patients was 26 ± 12 months. The mean GERD-HRQL score dropped significantly from 47/75 ± 17/75 to 12/75 ± 14/75 (p = .0003).
CONCLUSION
The LINX system may be used as an alternative to RYGB conversion in managing refractory post-SG reflux.
背景
袖状胃切除术（SG）后严重反流的治疗方法通常是转为 Roux-en-Y 胃旁路术（RYGB）。LINX 系统可能是一种替代治疗方法。
方法
2015 年至 2017 年间，有 13 名患者接受了 LINX 系统治疗 SG 后发生的反流。术前评估包括钡餐、pH 监测和食管动力内窥镜检查。
结果
13 名患者均为女性，平均年龄 49 ± 13 岁；男性 3 名，平均年龄 49 ± 13 岁。他们在放置 LINX 系统之前的平均体重为 193 ± 45 磅，平均 BMI 为 33 ± 6 kg/m。SG 和放置 LINX 系统之间的平均时间为 43 ± 19 个月。平均 Bravo 评分为 46 ± 26（正常为 14.7）。1 名患者术后出现严重吞咽困难，在 18 天后 LINX 系统被移除；1 名患者失访。其余 11 名患者的平均随访时间为 26 ± 12 个月。GERD-HRQL 评分从 47/75 ± 17/75 显著下降至 12/75 ± 14/75（p = 0.0003）。
结论
LINX 系统可作为治疗 SG 后难治性反流的 RYGB 转换的替代方法。
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