腹腔镜袖状胃切除术转换为单吻合口胃旁路术对胃食管反流病的临床影响
Clinical influence of conversion of laparoscopic sleeve gastrectomy to one anastomosis gastric bypass on gastroesophageal reflux disease.
作者信息
Rayman Shlomi, Staierman Maor, Assaf Dan, Rachmuth Jacob, Carmeli Idan, Keidar Andrei
机构信息
Department of General Surgery, Assuta Ashdod Public Hospital, affiliated with the Faculty of Health and Science at Ben-Gurion University, Ha-Refu'a St 7, 7747629, Ashdod, Israel.
Department of Surgery C, Chaim Sheba Medical Center, Tel Hashomer, Israel, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Derech Sheba 2, 52662, Ramat-Gan, Israel.
出版信息
Langenbecks Arch Surg. 2023 Apr 27;408(1):163. doi: 10.1007/s00423-023-02892-7.
PURPOSE
Assess the subjective impact of gastro-esophageal reflux disease (GERD) symptoms on patients undergoing revision from laparoscopic sleeve gastrectomy (LSG) to one-anastomosis gastric bypass (OAGB) using the Reflux Disease Questionnaire for GERD (RDQ) and the GERD-health related quality of life score (GERD-HRQL), prior to- and following conversion.
METHODS
Patients undergoing revision from LSG to OAGB were prospectively followed between May 2015 and December 2020. Data retrieved included demographics, anthropometrics, previous bariatric history, time interval between LSG and OAGB, weight loss, and co-morbidities. Pre- and post-OAGB RDQ and GERD-HRQL questionnaires were obtained. In the case of sleeve dilatation, sleeve resizing was performed.
RESULTS
During the study period, 37 patients underwent revision from LSG to OAGB. Mean ages at LSG and pre-OAGB were 38 ± 11.74 and 46 ± 12.75, respectively. Median follow-up time was 21.5 months (range 3-65). All patients underwent sleeve resizing. RDQ and GERD-HRQL scores were obtained at a median of 14 months (range 3-51) between pre- and post-OAGB. Median RDQ score pre-OAGB vs post-OAGB was significantly reduced (30 (range 12-72) vs 14 (range 12-60), p = 0.007). All 3 parts of the GERD- HRQL questionnaires were significantly reduced between pre-OAGB and post-OAGB: Symptoms (20; 62.5% vs 10; 31.3%, p = 0.012), overall score (15 (0-39) vs 7 (0-28), p = 0.04) and subjective improvement (10; 31% vs 20; 62.5%, p = 0.025).
CONCLUSION
Conversion of LSG to OAGB showed subjective improvement of GERD symptoms both in RDQ and in GERD-HRQL.
目的
使用反流性疾病问卷（RDQ）和GERD健康相关生活质量评分（GERD-HRQL），评估胃食管反流病（GERD）症状对接受从腹腔镜袖状胃切除术（LSG）转为单吻合口胃旁路术（OAGB）的患者的主观影响，在转换之前和之后进行评估。
方法
对2015年5月至2020年12月期间接受从LSG转为OAGB手术的患者进行前瞻性随访。收集的数据包括人口统计学、人体测量学、既往减肥手术史、LSG与OAGB之间的时间间隔、体重减轻情况以及合并症。获取OAGB术前和术后的RDQ和GERD-HRQL问卷。对于袖状胃扩张的情况，进行袖状胃尺寸调整。
结果
在研究期间，37例患者接受了从LSG转为OAGB的手术。LSG时和OAGB术前的平均年龄分别为38±11.74岁和46±12.75岁。中位随访时间为21.5个月（范围3 - 65个月）。所有患者均进行了袖状胃尺寸调整。在OAGB术前和术后的中位时间为14个月（范围3 - 51个月）时获得RDQ和GERD-HRQL评分。OAGB术前与术后的RDQ中位评分显著降低（30（范围12 - 72）对14（范围12 - 60），p = 0.007）。GERD-HRQL问卷的所有三个部分在OAGB术前和术后均显著降低：症状（20；62.5%对10；31.3%，p = 0.012）、总体评分（15（0 - 39）对7（0 - 28），p = 0.04）和主观改善（10；31%对20；62.5%，p = 0.025）。
结论
从LSG转为OAGB显示出GERD症状在RDQ和GERD-HRQL方面的主观改善。
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