Nosrati Saeid Shams, Pazouki Abdolreza, Sabzikarian Mohammad, Pakaneh Mohammadali, Kabir Ali, Kermansaravi Mohammad
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences(IUMS), Tehran, Iran.
Minimally Invasive Surgery Research Center, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Obes Surg. 2021 Jan;31(1):274-281. doi: 10.1007/s11695-020-04923-4. Epub 2020 Aug 18.
De novo gastroesophageal reflux disease (GERD) is one of the complications that may occur after laparoscopic sleeve gastrectomy (LSG). This study was conducted to examine whether omentopexy can be effective in reducing the incidence of GERD after LSG.
A total of 201 patients (145 females) were compared in this retrospective cohort study, including Group A (n = 100) and Group B (n = 101), consisting of patients undergoing LSG with omentopexy and LSG without omentopexy, respectively. One year after surgery, the patients were evaluated by GERD-Q; those obtaining a score of eight or above also underwent upper endoscopy to confirm their de novo GERD.
Thirty-seven patients had a GERD-Q score ≥ 8 and therefore underwent upper endoscopy. Seventeen patients had fully normal endoscopy results, and no significant differences was observed between the two groups in terms of the incidence of de novo GERD (P = 0.966). There were also no significant differences between the groups in terms of age (P = 0.517), sex (P = 0.193), diabetes (P = 0.979), and GERD-Q score (P = 0.880). The pre-operative mean weight (P = 0.003) and total weight loss (TWL) showed significant intergroup differences (P = 0.001). The mean body mass index (BMI) showed significant differences between the groups before the operation (P = 0.001) and 1 year after the surgery (P = 0.009). Excess BMI loss (EBMIL) was also significantly higher in Group A 1 year after the surgery (P = 0.004). Even after omitting confounder effect of BMI between two groups with and without omentopexy, GerdQ was not significantly different.
Omentopexy does not have a significant effect on reducing the incidence of de novo GERD after LSG, even in individuals with higher BMI and weight.
新发胃食管反流病（GERD）是腹腔镜袖状胃切除术（LSG）后可能出现的并发症之一。本研究旨在探讨网膜固定术是否能有效降低LSG后GERD的发生率。
在这项回顾性队列研究中，共比较了201例患者（145例女性），包括A组（n = 100）和B组（n = 101），分别为接受带网膜固定术的LSG患者和未接受网膜固定术的LSG患者。术后一年，采用GERD-Q对患者进行评估；GERD-Q评分达到8分及以上的患者还接受了上消化道内镜检查以确诊新发GERD。
37例患者GERD-Q评分≥8分，因此接受了上消化道内镜检查。17例患者内镜检查结果完全正常，两组新发GERD的发生率无显著差异（P = 0.966）。两组在年龄（P = 0.517）、性别（P = 0.193）、糖尿病（P = 0.979）和GERD-Q评分（P = 0.880）方面也无显著差异。术前平均体重（P = 0.003）和总体重减轻（TWL）显示出组间显著差异（P = 0.001）。平均体重指数（BMI）在术前（P = 0.001）和术后1年（P = 0.009）两组间均有显著差异。术后1年A组的超重体重指数降低（EBMIL）也显著更高（P = 0.004）。即使排除了有或无网膜固定术两组间BMI的混杂效应，GERD-Q也无显著差异。
网膜固定术对降低LSG后新发GERD的发生率无显著影响，即使是在BMI和体重较高的个体中。
