胃袖状切除术后病人发展为胃食管反流病的自然病程探讨

The natural course of patients developing gastroesophageal reflux disease after sleeve gastrectomy

胃食管反流病(GERD)在肥胖病人中高发,与体重变化密切相关。减重代谢手术可有效改善部分病人的GERD。然而,根据减重代谢手术的类型不同,也可能加重甚至引起新发的GERD。因此,对接受减重代谢手术,尤其是胃袖状切除术(SG)的病人而言,GERD需重点关注。受影响病人不仅身体机能下降,还面临心理和情绪困扰,进而导致社交能力下降。SG术后GERD的发病是由解剖、生理和物理等多因素互相作用导致,包括袖状胃的形状、术中对食管括约肌的损伤程度以及是否合并食管裂孔疝。治疗方案则包括生活方式改变、药物、介入治疗和(或)修正手术等多种方式。

Gastroesophageal reflux disease(GERD)is highly prevalent in obese patients and is closely related to weight changes.However,according to different types of bariatric and metabolic surgery,it may exacerbate or even induce new-onset GERD depending on the type of bariatric and metabolic surgery performed.Therefore,GERD remains a significant concern for patients undergoing bariatric and metabolic surgery,particularly sleeve gastrectomy(SG).Affected patients not only experience declining physical health but also face psychological and emotional distress,leading to decreased social functioning.The incidence of GERD after SG surgery is caused by the interaction of many factors such as anatomy,physiology,and physics,including the shape of the sleeve stomach,the degree of intraoperative injury to the esophageal sphincter,and whether esophageal hiatal hernia is complicated.Treatment options may include lifestyle modifications,medications,interventional therapies,and/or revisional surgery.