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中华胃食管反流病电子杂志 ›› 2024, Vol. 11 ›› Issue (04) : 208 -211. doi: 10.3877/cma.j.issn.2095-8765.2024.04.006

综述

肥胖合并食管裂孔疝患者减重手术方式现状
邢颖1, 闫文貌1, 白日星1,()   
  1. 1. 100070 北京,首都医科大学附属北京天坛医院普通外科
  • 收稿日期:2024-05-19 出版日期:2024-11-15
  • 通信作者: 白日星

Bariatric surgery in obese patients with esophageal hiatal hernia

Ying Xing1, Wenmao Yan1, Rixing Bai1,()   

  1. 1. Department of General Surgery, Beijing Tiantan Hospital, Beijing 100050, China
  • Received:2024-05-19 Published:2024-11-15
  • Corresponding author: Rixing Bai
引用本文:

邢颖, 闫文貌, 白日星. 肥胖合并食管裂孔疝患者减重手术方式现状[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(04): 208-211.

Ying Xing, Wenmao Yan, Rixing Bai. Bariatric surgery in obese patients with esophageal hiatal hernia[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(04): 208-211.

近年来随着减重与代谢手术逐步开展和手术例数的增加,对于肥胖合并食管裂孔疝(HH)或伴有胃食管反流病(GERD)患者,如何选择适宜的手术方式成为了学术界关注的热点。目前的研究表明肥胖合并HH或伴有GERD患者,腹腔镜下袖状胃切除术(LSG)无论是否联合HH时同步修补,在GERD改善方面的作用都不如胃旁路手术(RYGB),并且有可能导致新发GERD的出现。对于LSG后因GERD或合并HH接受修正手术的患者,RYGB可以获得良好控制GERD的效果,而且优于单吻合口胃旁路手术。因此,对于合并HH或伴有GERD的肥胖患者,RYGB可能是更为合适的减重术式。

In recent years, with the gradual development of bariatric surgery and the increase in the number of surgical cases, how to choose the appropriate surgical approach for patients with obesity and hiatus hernias (HH) or gastroesophageal reflux disease(GERD) has become a hot topic in the academic community. Current research shows that for patients with obesity and HH or GERD, laparoscopic sleeve gastrectomy(LSG), whether combined with hiatus hernias repair or not, is not as effective as Roux-en-Y gastric bypass (RYGB) in improving GERD, and may lead to the emergence of new GERD. For patients who undergo revision surgery due to GERD or HH after LSG, RYGB can achieve good control of GERD and is superior to one anastomosis gastric bypass. Therefore, for obese patients with HH or GERD, RYGB may be a more appropriate weight loss surgery.

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