Moon Rena C, Teixeira Andre F, Treto Jessica, Jawad Muhammad A
Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, FL.
Surg Laparosc Endosc Percutan Tech. 2020 Oct;30(5):464-466. doi: 10.1097/SLE.0000000000000816.
One of the most significant concerns after laparoscopic sleeve gastrectomy (LSG) is the new-onset or worsening of gastroesophageal reflux disease (GERD). Some patients with LSG undergo a conversion to Roux-en-Y gastric bypass (RYGB) because of severe GERD. Cardiopexy at the time of LSG may help prevent GERD. This study aims to examine the safety and effectiveness of cardiopexy at the time of LSG.
A retrospective chart review was performed on 161 consecutive patients who underwent LSG between May 1, 2017 and April 30, 2018. Of these, 79 underwent cardiopexy at the time of LSG. Weight, comorbidities, and complications were recorded at 6 months after LSG.
Baseline characteristics were similar between the cardiopexy and noncardiopexy groups of patients. In the cardiopexy group, 8 (10.1%) patients reported having GERD at the time of LSG, whereas 12 (14.6%) patients did in the noncardiopexy group. At 6 months after the procedure, 5 (8.9%) patients in the cardiopexy group reported symptoms of GERD, whereas 14 (17.7%) patients did in the noncardiopexy group (P=0.15). One (1.3%) patient in the cardiopexy group and 2 (2.4%) patients in the noncardiopexy group were converted to an RYGB because of severe reflux (P=0.58). The percentage of excess body mass index loss and the percentage of total weight loss were similar between the 2 groups.
Cardiopexy was not associated with a reduced rate of symptomatic GERD and conversion to RYGB after 6 months.
腹腔镜袖状胃切除术（LSG）后最令人担忧的问题之一是胃食管反流病（GERD）的新发或加重。一些接受LSG的患者因严重GERD而改行 Roux-en-Y 胃旁路术（RYGB）。LSG 时进行胃底固定术可能有助于预防 GERD。本研究旨在探讨 LSG 时胃底固定术的安全性和有效性。
对 2017 年 5 月 1 日至 2018 年 4 月 30 日期间连续接受 LSG 的 161 例患者进行回顾性病历审查。其中，79 例患者在 LSG 时进行了胃底固定术。记录 LSG 后 6 个月时的体重、合并症和并发症情况。
胃底固定术组和非胃底固定术组患者的基线特征相似。在胃底固定术组中，8 例（10.1%）患者在 LSG 时报告有 GERD，而非胃底固定术组中有 12 例（14.6%）患者有 GERD。术后 6 个月时，胃底固定术组中有 5 例（8.9%）患者报告有 GERD 症状，而非胃底固定术组中有 14 例（17.7%）患者有症状（P = 0.15）。胃底固定术组中有 1 例（1.3%）患者和非胃底固定术组中有 2 例（2.4%）患者因严重反流改行 RYGB（P = 0.58）。两组之间的超重体重指数损失百分比和总体重减轻百分比相似。
胃底固定术与术后 6 个月时症状性 GERD 的发生率降低及改行 RYGB 无关。
