胃近端切除术后后凸与胃食管反流的关系

IF 3.3 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Takaomi Ozawa, Suguru Maruyama, Katsutoshi Shoda, Yoshihiko Kawaguchi, Ryo Saito, Kensuke Shiraishi, Shinji Furuya, Hidetake Amemiya, Hiromichi Kawaida, Daisuke Ichikawa
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引用次数: 0

摘要

目的随着预期寿命的延长,脊柱后凸的发病率呈上升趋势。后凸患者最显著的胃肠道并发症之一是胃食管反流病(GERD)。在这项研究中,我们调查了接受近端胃切除术(PG)的患者后凸与术后胃反流发生率之间的关系,这是一种特别高风险的胃反流手术。方法在2009年至2023年期间,共有54例连续接受PG的患者符合纳入标准。术前进行矢状位计算机断层扫描得出的胸腰椎角度比(T/L比)评估后凸,定义为T/L比≥1.25。结果15例(27.8%)出现后凸。总体而言,7例(13.0%)患者发生术后反流。后凸组术前白蛋白水平明显低于正常组(p = 0.03),而其他临床特征在两组间无显著差异。后凸组术后胃食管反流发生率明显高于正常组(33.3% vs. 5.1%, p = 0.01)。术后反流症状在后凸组也比正常组更常见(60.0%比16.0%,p = 0.13)。多因素分析中,后凸是术后胃食管反流的独立预测因素之一(优势比18.7;95%可信区间1.46 ~ 240;p = 0.02)。结论脊柱后凸与PG术后胃食管反流的发生有显著相关性,脊柱后凸患者行PG时可考虑采取其他预防措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Relationship Between Kyphosis and Postoperative Gastroesophageal Reflux After Proximal Gastrectomy

Relationship Between Kyphosis and Postoperative Gastroesophageal Reflux After Proximal Gastrectomy

Aim

The prevalence of kyphosis is increasing with increasing life expectancy. One of the most notable gastrointestinal complications is gastroesophageal reflux disease (GERD) in patients with kyphosis. In this study, we investigated the association between kyphosis and the incidence of postoperative GERD in patients who underwent proximal gastrectomy (PG), a procedure with a particularly high risk of GERD.

Methods

In total, 54 consecutive patients who underwent PG between 2009 and 2023 met the inclusion criteria. The thoracic/lumbar angle ratio (T/L ratio) derived from sagittal computed tomography was performed to preoperatively assess kyphosis, defined as a T/L ratio ≥ 1.25.

Results

Fifteen patients (27.8%) had kyphosis. Overall, postoperative GERD occurred in seven patients (13.0%). Preoperative albumin levels were significantly lower in the Kyphosis group than in the Normal group (p = 0.03), whereas other clinical characteristics showed no significant differences between the two groups. The incidence of postoperative GERD was significantly higher in the Kyphosis group than in the Normal group (33.3% vs. 5.1%, p = 0.01). Postoperative reflux symptoms also were more frequently observed in the Kyphosis group than in the Normal group (60.0% vs. 16.0%, p = 0.13). Kyphosis was one of the independent predictive factors for postoperative GERD (Odds ratio, 18.7; 95% confidence interval, 1.46–240; p = 0.02) in the multivariate analysis.

Conclusion

Kyphosis was significantly associated with the occurrence of postoperative GERD in patients who underwent PG. Alternative preventive measures may be considered when patients with kyphosis undergo PG.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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