Department of Surgery, S.I.C.OB. (Italian Society of Bariatric Surgery) Referral Center for Bariatric Surgery, Policlinico San Marco, GSD University and Research, Bergamo, Italy; Vita-Salute San Raffaele University, Milano, Italy.
Department of Surgery, S.I.C.OB. (Italian Society of Bariatric Surgery) Referral Center for Bariatric Surgery, Policlinico San Marco, GSD University and Research, Bergamo, Italy; University of Milan, Milano, Italy.
Surg Obes Relat Dis. 2021 Jun;17(6):1057-1065. doi: 10.1016/j.soard.2021.01.007. Epub 2021 Jan 21.
Laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric procedure. Recent studies demonstrated the correlation between LSG and gastroesophageal reflux disease (GERD).
To evaluate the effectiveness of LSG + Rossetti antireflux fundoplication in patients affected by morbid obesity and GERD.
High-volume bariatric center, Italy.
This is a prospective, observational cohort study that enrolled 58 patients affected by obesity and GERD who underwent surgery. All the patients had a 12-month follow-up. Gastroscopies were performed preoperatively and at month 12 for 35 patients.
At 1 year after surgery, patients had a consistent decrease in body mass index, from 41.9 ± 4.6 kg/m to 28.2 ± 3.7 kg/m. GERD improved in 97.1% of patients. Co-morbidities, such as hypertension, type 2 diabetes, respiratory dysfunction, and arthropathies improved as well. The visual analogue scale score regarding the global state of health increased significantly, from 58.1 ± 17.1% before surgery to 98.8 ± 4.1% at 1 year after surgery. Two patients had a fundoplication perforation and needed reparative surgery (3.5%). One patient had anemia that needed a blood transfusion (1.7%). Complications were reduced with a learning curve.
LSG + Rossetti fundoplication was shown to be a safe and effective intervention. It could be considered an option in obese patients affected by GERD. A longer follow-up is needed to establish the long-term outcomes.
腹腔镜袖状胃切除术（LSG）是最常施行的减重手术。最近的研究表明，LSG 与胃食管反流病（GERD）之间存在相关性。
评估 LSG+Rossetti 抗反流胃底折叠术治疗肥胖合并 GERD 患者的疗效。
意大利高容量减重中心。
这是一项前瞻性观察队列研究，共纳入 58 例肥胖合并 GERD 患者，所有患者均接受了手术治疗。所有患者均进行了为期 12 个月的随访。35 例患者在术前和术后第 12 个月接受了胃镜检查。
术后 1 年，患者的体重指数从 41.9±4.6kg/m²持续下降至 28.2±3.7kg/m²，GERD 改善率为 97.1%。高血压、2 型糖尿病、呼吸功能障碍和关节炎等合并症也得到改善。总体健康状况的视觉模拟评分（VAS）显著提高，从术前的 58.1±17.1%提高至术后 1 年的 98.8±4.1%。2 例患者发生胃底折叠术穿孔，需要进行修复手术（3.5%）。1 例患者发生贫血，需要输血（1.7%）。并发症随着学习曲线的变化而减少。
LSG+Rossetti 抗反流胃底折叠术是一种安全有效的治疗方法。对于肥胖合并 GERD 的患者，可考虑作为一种选择。需要更长时间的随访来确定长期疗效。
