General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt.
Pathology Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt.
Obes Surg. 2020 Aug;30(8):3037-3045. doi: 10.1007/s11695-020-04648-4.
Sleeve gastrectomy (SG) is an effective bariatric procedure, yet can be associated with complications as gastroesophageal reflux disease (GERD). The present study aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in SG specimens, its relation with GERD, and its impact on postoperative outcomes.
All SG specimens received in the pathology laboratory were reviewed. The prevalence of H. pylori in SG specimens was recorded. Patients with H. pylori infection who received triple therapy were compared with patients without H pylori in terms of baseline characteristics, preoperative GERD and its outcome postoperatively, development of new-onset GERD, staple line complications, and weight loss.
The records of 176 patients were reviewed; 69 (39.2%) were positively tested on H. pylori infection. Patients with H. pylori had higher body mass index (BMI) (RR = 1.51), greater incidence of preoperative GERD (RR = 1.67), and complained more of dyspepsia (RR = 1.87). Eradication of H. pylori was achieved in 67 (97.1%) of 69 patients. Postoperative improvement in GERD symptoms (44.4% Vs 19%, p = 0.036) and dyspepsia (85.7% Vs 51.7%, p = 0.007) was higher in patients with H. pylori with confirmed eradication of infection than patients without H. pylori. Both groups had similar operation time, postoperative BMI, excess weight loss, staple line complications, and new-onset GERD.
More than one-third of patients with morbid obesity had H. pylori infection. Morbidly obese patients with H. pylori infection may be more prone to develop GERD symptoms; yet after eradication of the infection, they may also experience better improvement in symptoms after SG.
袖状胃切除术（SG）是一种有效的减重手术，但也可能与胃食管反流病（GERD）等并发症相关。本研究旨在探讨 SG 标本中幽门螺杆菌（H. pylori）的流行情况，及其与 GERD 的关系，以及对术后结果的影响。
回顾了所有送到病理实验室的 SG 标本。记录了 SG 标本中 H. pylori 的流行情况。对接受三联疗法治疗的 H. pylori 感染患者与未感染 H. pylori 的患者进行比较，比较内容包括基线特征、术前 GERD 及其术后结果、新发 GERD 的发展、吻合口并发症和体重减轻。
共回顾了 176 例患者的记录，其中 69 例（39.2%） H. pylori 感染检测呈阳性。H. pylori 感染患者的体重指数（BMI）更高（RR=1.51），术前 GERD 的发生率更高（RR=1.67），且消化不良的发生率更高（RR=1.87）。69 例 H. pylori 感染患者中，有 67 例（97.1%）成功根除了 H. pylori。感染根除的 H. pylori 患者术后 GERD 症状（44.4%比 19%，p=0.036）和消化不良（85.7%比 51.7%，p=0.007）的改善程度更高。两组患者的手术时间、术后 BMI、体重减轻过量、吻合口并发症和新发 GERD 发生率相似。
超过三分之一的病态肥胖患者感染了 H. pylori。感染 H. pylori 的病态肥胖患者可能更容易出现 GERD 症状；但在根除感染后，他们在 SG 后也可能出现更好的症状改善。
