Department of Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany.
Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
Updates Surg. 2023 Jun;75(4):967-977. doi: 10.1007/s13304-023-01477-9. Epub 2023 Feb 27.
One of the most severe side effects of sleeve gastrectomy (SG) is the development or aggravation of reflux disease. This study investigates the effect of SG on the development of reflux disease and the variables that may impact this development. In addition, trends in revision surgery, weight, and comorbidity are examined among patients with reflux disease and SG and those without reflux disease and SG. This study includes 3379 individuals without reflux disease who had primary SG and were followed for three years. The demographic characteristics, comorbidities, technical features, and complications of SG were analyzed. Data were collected by the German Bariatric Surgery Registry (GBSR). 860 (25.45%) Group A patients had reflux disease following SG (Group B: no reflux after SG; 74.55%). Patients with reflux disease had longer operating times (83.8 min vs. 77.5 min, p < 0.001) and longer postoperative hospital admissions (6 days vs. 5.5 days). In group A, the %EWL was substantially greater than in group B (64.1 vs. 61.1%). 42 patients were converted from SG to RYGB (4.88%), 2 had hiatoplasty, and 5 got Endostim. There is no significant variation in perioperative complications (p value > 0.05). The incidence of complete remission of sleep apnea was higher in group A than in group B (p = 0.013; 50% vs. 44.8%). Other comorbidities were not substantially different. Reflux illness after SG is still poorly understood, despite much research. Technical and preoperative variables may promote its development. However, these assumptions remain theoretical and are not confirmed by scientific data. The majority of patients may be successfully treated using non-invasive methods, although sometimes further surgery is necessary. Despite our results and the literature, this subject is intriguing for further research.
袖状胃切除术 (SG) 最严重的副作用之一是反流性疾病的发展或加重。本研究调查了 SG 对反流性疾病发展的影响，以及可能影响这种发展的变量。此外，还检查了患有反流性疾病和 SG 的患者与没有反流性疾病和 SG 的患者之间的翻修手术、体重和合并症的趋势。本研究包括 3379 名没有反流性疾病的患者，他们接受了原发性 SG 治疗，并随访了三年。分析了 SG 的人口统计学特征、合并症、技术特征和并发症。数据由德国减肥手术登记处 (GBSR) 收集。860 名 (25.45%) A 组患者在 SG 后出现反流性疾病 (B 组：SG 后无反流；74.55%)。患有反流性疾病的患者手术时间更长 (83.8 分钟比 77.5 分钟，p<0.001)，术后住院时间更长 (6 天比 5.5 天)。在 A 组中，%EWL 明显大于 B 组 (64.1%比 61.1%)。42 名患者从 SG 转为 RYGB (4.88%)，2 名患者行胃底折叠术，5 名患者接受 Endostim 治疗。围手术期并发症无明显差异 (p 值>0.05)。A 组完全缓解睡眠呼吸暂停的发生率高于 B 组 (p=0.013；50%比 44.8%)。其他合并症没有显著差异。尽管进行了大量研究，但 SG 后反流性疾病仍知之甚少。技术和术前变量可能促进其发展。然而，这些假设仍然是理论上的，并没有被科学数据所证实。大多数患者可能可以通过非侵入性方法成功治疗，尽管有时需要进一步手术。尽管我们的结果和文献表明，这个问题很有研究价值。
