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腹腔镜袖状胃切除术对胃食管反流病的影响及基于生活质量的发生相关因素。

Impact of Laparoscopic Sleeve Gastrectomy on Gastroesophageal Reflux Disease and Risk Factors Associated with Its Occurrence Based Upon Quality of Life.

机构信息

Surgery Department, Faculty of Medicine, King Khalid University, P.O.: 641, Abha, 61421, Saudi Arabia.

General Surgery Department, Aseer Central Hospital, Abha, Saudi Arabia.

出版信息

Obes Surg. 2021 Jul;31(7):3065-3074. doi: 10.1007/s11695-021-05347-4. Epub 2021 Mar 29.

Abstract

BACKGROUND

To assess the impact of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) symptoms and to determine factors associated with the occurrence of post-LSG GERD symptoms.

MATERIAL AND METHODS

This is a retrospective study that included all obese patients who underwent LSG in Aseer Central Hospital, during the period from August 2017 to August 2019. GERD-Health-Related Quality of Life questionnaire was used to assess the patients' pre- and postoperative GERD symptoms and their satisfaction toward their general health.

RESULTS

The study included 326 patients (195 males and 131 females) with a mean age of 39.43 ± 11.17 years. Postoperatively, GERD symptoms newly developed in 105 patients (32.2%), while 25 patients out of 127 with preoperative GERD symptoms (19.69%) showed resolution of symptoms. There were significant associations (p < 0.001) between the old age, smoking and existence of comorbidities, and the occurrence of postoperative heartburn and regurgitation symptoms. Postoperatively, excess weight loss (EWL) was significantly associated with postoperative regurgitation (p = 0.045) and patients showed significant improvement in their satisfaction toward their health condition even those who developed GERD symptoms.

CONCLUSIONS

After LSG, GERD symptoms developed in about one-third of the patients while symptoms improved in only one-fifth of patients. Older patients, smokers, patients with comorbidities, and patients with more EWL had significantly worse GERD symptoms postoperatively. Weight loss rather than GERD symptoms significantly influenced patients' satisfaction toward their general health. Further prospective studies are needed to determine the relationship between weight loss and other factors associated with post-LSG reflux and overall quality of life.

摘要

背景

评估腹腔镜袖状胃切除术(LSG)对胃食管反流病(GERD)症状的影响,并确定与术后 LSGERD 症状发生相关的因素。

材料和方法

这是一项回顾性研究,纳入了 2017 年 8 月至 2019 年 8 月期间在阿西尔中央医院接受 LSG 的所有肥胖患者。使用胃食管反流病健康相关生活质量问卷评估患者术前和术后的 GERD 症状及其对总体健康状况的满意度。

结果

该研究共纳入 326 例患者(男性 195 例,女性 131 例),平均年龄为 39.43 ± 11.17 岁。术后,105 例(32.2%)患者出现新的 GERD 症状,而 127 例术前存在 GERD 症状的患者中(19.69%)有 25 例症状缓解。年龄较大、吸烟和并存疾病与术后烧心和反流症状的发生存在显著相关性(p<0.001)。术后,体重减轻过多(EWL)与术后反流显著相关(p=0.045),即使出现 GERD 症状,患者对健康状况的满意度也显著提高。

结论

LSG 术后约三分之一的患者出现 GERD 症状,而只有五分之一的患者症状改善。年龄较大、吸烟、并存疾病和 EWL 较大的患者术后 GERD 症状明显更差。体重减轻而不是 GERD 症状显著影响患者对总体健康状况的满意度。需要进一步的前瞻性研究来确定体重减轻与与 LSGERD 后反流和总体生活质量相关的其他因素之间的关系。

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