腹腔镜袖带胃切除术前和术后五年的内镜效果:影响显著吗?

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-09-23 eCollection Date: 2024-09-01 DOI:10.7759/cureus.70009
Owaid M Almalki, Tamer M Abdelrahman, Mohammed E Mukhliss, Dhuha A Alhumaidi
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引用次数: 0

摘要

腹腔镜袖带胃切除术(LSG)是一种流行的减肥手术,对体重和代谢健康有显著效果。然而,它对胃食管反流病(GERD)和食管症状的影响仍存在争议。本研究旨在评估 LSG 术后五年的内镜变化。我们对2017年6月至2019年6月期间在本中心接受LSG的患者进行了回顾性分析。纳入标准包括术前和至少五年的随访食管胃十二指肠镜(EGD)检查。我们分析了人口统计学因素、食管症状和内镜检查结果。在接受 LSG 的 118 名患者中,有 24 名符合纳入标准。有两名患者因转为 Roux-en-Y 胃旁路术 (RYGB) 而被排除在外。最终纳入的 22 名患者平均年龄为 42 ± 10 岁,平均体重指数为 45 ± 7 kg/m²。术前胃食管造影显示,21 名患者(95.5%)无胃食管反流,1 名患者(4.5%)有胃食管反流。食道症状包括烧心(54.5%)、恶心(36.4%)、反胃(31.8%)和上腹痛(22.7%)。据报告,10 名患者(45.5%)使用了 PPI 或抗酸剂。食道外症状很少见。胃食管反流患者的体重指数(34.5 ± 6.3 kg/m²)明显高于非胃食管反流患者(30.2 ± 5.1 kg/m²,p = 0.04)。尽管大多数患者的胃食管反流病在五年内没有明显变化,但 LSG 可能会导致一部分患者的胃食管反流病发展或恶化。持续监测和量身定制的管理策略对于优化治疗效果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic Outcomes Before and Five Years After Laparoscopic Sleeve Gastrectomy: Is There a Significant Impact?

Laparoscopic sleeve gastrectomy (LSG) is a popular bariatric procedure with significant effects on weight and metabolic health. However, its impact on gastroesophageal reflux disease (GERD) and esophageal symptoms remains debated. This study aims to evaluate the endoscopic changes five years post-LSG. We conducted a retrospective analysis of patients who underwent LSG at our center between June 2017 and June 2019. Inclusion criteria included preoperative and at least five-year follow-up esophagogastroduodenoscopy (EGD). We analyzed demographic factors, esophageal symptoms, and endoscopic findings. Out of 118 patients who underwent LSG, 24 met the inclusion criteria. Two patients were excluded due to conversion to Roux-en-Y gastric bypass (RYGB). The final cohort included 22 patients with a mean age of 42 ± 10 years and a mean BMI of 45 ± 7 kg/m². Preoperative EGD showed no GERD in 21 patients (95.5%) and GERD in 1 patient (4.5%). At five-year follow-up, 14 patients (63.6%) had no GERD, 7 (31.8%) had GERD A, and 1 (4.5%) had GERD B. Esophageal symptoms included heartburn (54.5%), nausea (36.4%), regurgitation (31.8%), and epigastric pain (22.7%). PPI or antacid use was reported in 10 patients (45.5%). Extra-esophageal symptoms were rare. BMI was significantly higher in patients with GERD (34.5 ± 6.3 kg/m²) compared to those without GERD (30.2 ± 5.1 kg/m², p = 0.04). LSG may lead to the development or worsening of GERD in a subset of patients, despite the majority showing no significant GERD changes over five years. Continuous monitoring and tailored management strategies are essential for optimizing outcomes.

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