Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, Saitama Jikei Hospital, Saitama, Japan.
Asian J Endosc Surg. 2024 Apr;17(2):e13306. doi: 10.1111/ases.13306.
Laparoscopic sleeve gastrectomy (LSG) is the most frequently performed procedure in bariatric-metabolic surgery (BMS) worldwide, accounting for approximately 90% of BMS procedures in Japan. While numerous studies have reported on the safety and efficacy of LSG, gastroesophageal reflux disease (GERD) remains a major postoperative complication. Although Roux-en-Y gastric bypass (RYGB) is preferred for severe obesity with GERD, it is less suitable for Japanese patients who have a higher risk of gastric cancer due to the remnant stomach which is difficult to observe with esophago-gastro-duodenoscopy. To address de novo and exacerbation GERD after LSG, we conducted LSG with Toupet fundoplication (T-sleeve) for Japanese patients with severe obesity. In our first T-sleeve case, the patient demonstrated sufficient weight loss and improved GERD following surgery. Hence, we suggest that T-sleeve is a feasible option for Japanese patients with obesity and concurrent GERD.
腹腔镜袖状胃切除术（LSG）是全球范围内最常进行的减重代谢手术（BMS）程序，约占日本 BMS 程序的 90%。虽然有许多研究报告了 LSG 的安全性和有效性，但胃食管反流病（GERD）仍然是主要的术后并发症。虽然 Roux-en-Y 胃旁路术（RYGB）适用于伴有 GERD 的严重肥胖症，但对于由于胃癌风险较高而残留胃难以通过食管胃十二指肠镜观察的日本患者来说，它不太适合。为了解决 LSG 后新发和加重的 GERD，我们对严重肥胖的日本患者进行了带 Toupet 瓣的 LSG（T-sleeve）。在我们的第一个 T-sleeve 病例中，患者在手术后表现出足够的体重减轻和 GERD 改善。因此，我们认为 T-sleeve 是肥胖症合并 GERD 的日本患者的一种可行选择。
