Khallouf Joe, Gaspar Figueiredo Sergio, Demartines Nicolas, Schoepfer Alain, Schäfer Markus, Mantziari Styliani
Service de chirurgie viscérale, CHUV, 1011 Lausanne.
Service de gastroentérologie et hépatologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2020 Jul 1;16(699):1287-1291.
Gastroesophageal reflux disease (GERD) has a high prevalence in the obese population with a direct correlation between increased BMI and GERD. This correlation is multifactorial, with also more complicated forms (esophagitis and metaplasia) present in obese patients, even in the absence of frank reflux symptoms. Therapeutic success largely depends on weight loss, and bariatric surgery is the cornerstone of treatment for both diseases. Roux-en-Y gastric bypass is the intervention of choice for obese patients suffering from GERD, while sleeve gastrectomy can on the contrary induce increased reflux in the long term. Classic anti-reflux surgery (fundoplication) can also be offered to these patients, while being aware of the high risk of recurrent symptoms for BMI > 30-35 kg/m2.
胃食管反流病（GERD）在肥胖人群中患病率较高，体重指数（BMI）增加与GERD之间存在直接关联。这种关联是多因素的，即使在没有明显反流症状的肥胖患者中，也存在更复杂的形式（食管炎和化生）。治疗成功很大程度上取决于体重减轻，减肥手术是这两种疾病治疗的基石。Roux-en-Y胃旁路术是GERD肥胖患者的首选干预措施，而袖状胃切除术相反在长期可能会导致反流增加。也可以为这些患者提供经典的抗反流手术（胃底折叠术），同时要意识到BMI>30-35kg/m2时症状复发的高风险。
