Cao C, Xu B, Yao Q Y
Center for Bariatric and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Nov 25;26(11):1082-1087. doi: 10.3760/cma.j.cn441530-20230411-00119.
Bariatric surgery, as the most effective approach to treating obesity at present, encompasses a wide array of procedures. However, due to the significant anatomical changes to the gastrointestinal tract caused by most of these procedures, they are associated with certain risks of complications. In the pursuit of minimizing trauma, bariatric surgeons have begun exploring new surgeries in addition to traditional procedures. Gastric plication surgeries encompass various procedures such as gastric fundoplication, gastric greater curvature plication, endoscopic sleeve gastroplasty, combined gastric fundoplication with gastric greater curvature plication, and combined gastric fundoplication with sleeve gastrectomy, among others. The efficacy and risks of complications associated with these procedures fall between those of medical therapy and sleeve gastrectomy. Gastric fundoplication, functioning as an anti-reflux procedure, can also be integrated into weight loss surgical interventions to effectively address obesity-related gastroesophageal reflux disease in obese patients. Both gastric greater curvature plication and endoscopic sleeve gastroplasty yield favorable weight loss outcomes. Beyond the impact of folding procedures on body mass, gastric plication surgeries can also be combined with other techniques. The combination of gastric fundoplication with sleeve gastrectomy or greater curvature plication can reduce body mass and mitigate reflux, while the combination of greater curvature plication with gastric bypass and similar procedures can further enhance weight loss and metabolic improvements.
减肥手术作为目前治疗肥胖症最有效的方法，涵盖了一系列手术。然而，由于这些手术中的大多数会导致胃肠道显著的解剖学变化，它们存在一定的并发症风险。为了尽量减少创伤，减肥外科医生除了传统手术外，还开始探索新的手术方法。胃折叠手术包括多种术式，如胃底折叠术、胃大弯折叠术、内镜下袖状胃成形术、胃底折叠术联合胃大弯折叠术以及胃底折叠术联合袖状胃切除术等。这些手术的疗效和并发症风险介于药物治疗和袖状胃切除术之间。胃底折叠术作为一种抗反流手术，也可纳入减肥手术干预中，以有效解决肥胖患者中与肥胖相关的胃食管反流病。胃大弯折叠术和内镜下袖状胃成形术都能产生良好的减肥效果。除了折叠手术对体重的影响外，胃折叠手术还可与其他技术相结合。胃底折叠术与袖状胃切除术或大弯折叠术联合使用可减轻体重并缓解反流，而大弯折叠术与胃旁路手术及类似手术联合使用可进一步增强减肥效果并改善代谢。
