St. John Hospital and Medical Center, Detroit, MI, USA.
St. John Hospital and Medical Center, Detroit, MI, USA.
Am J Surg. 2019 Mar;217(3):496-499. doi: 10.1016/j.amjsurg.2018.10.040. Epub 2018 Oct 29.
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.
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.
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).
The LINX system may be used as an alternative to RYGB conversion in managing refractory post-SG reflux.
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。
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。
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）。
LINX 系统可作为治疗 SG 后难治性反流的 RYGB 转换的替代方法。
