腹腔镜胃袖状切除联合食管裂孔疝修补术治疗肥胖合并胃食管反流病疗效Meta分析

Meta analysis of the efficacy of sleeve gastrectomy combined with esophageal hiatal hernia repair in the treatment of obesity complicated with gastroesophageal reflux disease

目的评价腹腔镜胃袖状切除联合食管裂孔疝修补术(LSG+HHR)治疗肥胖合并胃食管反流病(GERD的疗效。方法计算机检索PubMed、EMbase、The Cochrane Library、万方数据、中国知网等数据库,按照纳入标准和排除标准筛选文献,提取纳入文献的相关数据,并对其进行方法学质量评价和Meta分析。结果共纳入9篇文献、499例病人。Meta分析结果显示,LSG+HHR手术前后BMI(MD=11.92,95%CI 12.68~13.15,P<0.001)、GERD症状(OR=3.35,95%CI 1.15~9.75,P=0.03)以及术后GERD症状缓解率(OR=0.53,95%CI 0.19~0.87,P=0.002)比较差异有统计学意义。结论LSG+HHR可改善GERD病症,也可预防无症状病人中新GERD症状的出现,术后GERD症状缓解提高明显。

ObjectiveTo evaluate the efficacy of laparoscopic sleeve gastrectomy combined with esophageal hiatalherniorrhaphy(LSG+HHR)in the treatment of obesity complicated with gastroesophageal reflux disease(GERD).MethodsThe databases of Pub Med,EMbase,The Cochrane Library,Wanfang and CNKI were searched by computer,and the literatures were screened according to the inclusion criteria and exclusion criteria.The relevant data wereextracted,and the methodological quality evaluation and Meta analysis were carried out.ResultsA total of 9 articlesand 499 patients were included.The results of Meta analysis showed that there was significant difference in the changesof BMI before and after LSG+HHR operation(MD=11.92,95%CI 12.68-13.15,P<0.001).The weight loss of patientsafter LSG+HHR was more obvious than that before operation.There was significant difference in GERD symptoms beforeand after LSG+HHR operation(OR=3.35,95%CI 1.15-9.75,P=0.03).GERD symptoms were significantly relieved afterLSG+HHR,GERD symptom remission rate after LSG+HHR operation was significantly different(OR=0.53,95%CI 0.19-0.87,P=0.002),and GERD symptom remission rate after LSG+HHR was obvious.ConclusionLSG+HHR canimprove GERD,and prevent the occurrence of new GERD symptoms in asymptomatic patients.The remission rate ofGERD symptoms is significantly increased after operation.