袖状胃切除术、单吻合口胃旁路术、袖状胃切除联合胃空肠吻合术治疗肥胖合并胃食管反流的疗效分析

doi:10.3877/cma.j.issn.2095-8765.2025.01.002

中华胃食管反流病电子杂志 ›› 2025, Vol. 12 ›› Issue (01) : 10 -16. doi: 10.3877/cma.j.issn.2095-8765.2025.01.002

论著

袖状胃切除术、单吻合口胃旁路术、袖状胃切除联合胃空肠吻合术治疗肥胖合并胃食管反流的疗效分析

康星¹, 夏雪峰²^,³, 俞杭¹^,³, 褚薛慧¹, 孙喜太¹^,^†(

)

¹210000　南京大学医学院附属鼓楼医院胰腺与代谢外科
²210000　南京大学附属鼓楼医院胃与疝外科
³210046　南京大学医学院附属泰康仙林鼓楼医院普外科

收稿日期:2024-09-27 出版日期:2025-02-15
通信作者: 孙喜太

Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass and single anastomosis sleeve ileal in the treatment of obesity combined with gastroesophageal reflux disease

Xing Kang¹, Xuefeng Xia²^,³, Hang Yu¹^,³, Xuehui Chu¹, Xitai Sun¹^,^†()

¹Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210000, China
²Department of Gastric and Hernia Surgery, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210000, China
³Department of Surgery, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210046, China

Received:2024-09-27 Published:2025-02-15
Corresponding author: Xitai Sun

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引用本文：

康星, 夏雪峰, 俞杭, 褚薛慧, 孙喜太. 袖状胃切除术、单吻合口胃旁路术、袖状胃切除联合胃空肠吻合术治疗肥胖合并胃食管反流的疗效分析[J/OL]. 中华胃食管反流病电子杂志, 2025, 12(01): 10-16.

Xing Kang, Xuefeng Xia, Hang Yu, Xuehui Chu, Xitai Sun. Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass and single anastomosis sleeve ileal in the treatment of obesity combined with gastroesophageal reflux disease[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2025, 12(01): 10-16.

目的

分析袖状胃切除术（SG)、单吻合口胃旁路术（OAGB）、袖状胃切除联合胃空肠吻合术（SASI）治疗肥胖合并胃食管反流的疗效。

方法

纳入2022年6月至2023年6月于南京大学医学院附属鼓楼医院减重代谢外科住院行减重手术的肥胖合并GERD的患者95例，根据手术方式分为SG组（35例）、OAGB组（28例）、SASI组（32例）。对比分析3组患者术前、术后6个月、术后12个月的体质量、体质量指数（BMI）、腰围、多余体质量降低百分比（EWL%）变化情况，对比分析手术前后患者合并糖尿病、GERD和食管炎的情况。

结果

3组患者术后6个月和12个月记录到显著的体质量减轻；此外，SG组患者术后有明显不适，包括反酸、腹胀等，而行SASI的患者术后腹泻次数增多，OAGB组患者术后胃绞痛的发生率较高；术后3组的GERD好转情况存在明显差异（P<0.05）；根据术后胃镜以及量表评估结果，SASI组患者GERD缓解情况明显优于SG组和OAGB组。

结论

相较于OAGB和SG，SASI治疗肥胖合并GERD是最优选择，但其长期效果仍有待观察。此外，胃肠吻合口的大小以及胆胰肢长度的选择更需要认真总结经验及合理的循证研究。

关键词: 减重代谢手术, 胃食管反流病, 肥胖症

Objective

The quality of life of obese patients is frequently reduced due to comorbid gastroesophageal reflux disease (GERD), and bariatric metabolic surgery has been widely used as an effective treatment. Currently, whether GERD is complicating the postoperative period of different weight loss procedures is still controversial, making the choice of surgical procedure a key issue in the clinical management of obese patients. In this study, we retrospectively analysed the postoperative efficacy of sleeve gastrectomy, single-anastomosis gastric bypass and sleeve gastrectomy combined with gastrojejunostomy, and their complications of GERD in obese patients at our centre.

Methods

We included 95 patients with obesity combined with GERD who underwent bariatric surgery in the Department of Bariatric and Metabolic Surgery, Gulou Hospital, School of Medicine, Nanjing University, from June 2022 to June 2023, and divided them into three groups according to the surgical methods, namely, sleeve gastrectomy (SG) (35 patients), one-anastomosis gastric bypass (OAGB) (28 patients), and single anastomosis sleeve ileal (SASI) (32 patients). The weight, body mass index (BMI), change in waist circumference, and percentage of excess weight loss (EWL%) of the patients in the three groups were compared before surgery, at 6 months after surgery, and at 1 year after surgery, and the patients’ comorbidities of diabetes mellitus, GERD, and esophagitis were compared before and after surgery.

Results

Significant body mass reduction was recorded at 6 and 12 months after surgery in the 3 groups; in addition, patients in the SG group had significant postoperative discomfort, including acid reflux and abdominal distension, whereas those who underwent SASI had more postoperative diarrhea, and the incidence of postoperative gastric colic was higher in the patients in the OAGB group; there was a significant difference in the improvement of GERD among the 3 groups postoperatively (P<0.05); according to postoperative gastroscopy as well as scale assessment results, GERD remission in patients in the SASI group was significantly better than that in the SG and OAGB groups.

Conclusion

Compared with OAGB and SG, SASI is the optimal choice for the treatment of obesity-combined GERD, but its long-term effect remains to be observed. In addition, the size of gastrointestinal anastomosis and the choice of the length of biliopancreatic limb need more careful experience and reasonable evidence-based research.

Key words: Bariatric and metabolic surgery, Gastroesophageal Reflux Disease, Obesity

表1 3组患者一般资料比较

指标	SG组（35例）	OAGB组（28例）	SASI组（32例）	P值
年龄（岁，±s）	27.05±7.6	33.6±5.3	34.9±6.8	0.203
性别（男性/女性）	19/16	15/13	17/15	0.312
BMI（kg/m²，±s）	34.7±6.2	39.5±4.9	38.2±5.8	0.214
体质量（kg，±s）	107.7±23.8	102.8±17.3	105.5±18	0.059
腰围（cm，±s）	118.0±12.9	115.0±10.7	116.8±11.2	0.187
臀围（cm，±s）	110.8±7.3	112.6±6.3	108.7±8.9	0.317
糖化血红蛋白（%，±s）	6.0±1.2	5.9±2.4	6.9±2.3	0.235
血红蛋白（g/L，±s）	129.4±8.6	117.9±7.1	126.7±19.1	0.187
空腹血糖（mmol/L，±s）	6.2±2.1	7.1±2.2	7.2±2.9	0.218
白蛋白（g/L，±s）	41.5±3.5	41.8±3.4	44.5±4.6	0.282
甘油三酯（mmol/L，±s）	2.1±2.2	2.0±1.2	2.3±1.9	0.201
维生素B12（pg/ml，±s）	493.5±188.1	490.1±221.9	513.3±273.5	0.264
25羟基维生素D（±s）	15.2±4.3	13.1±7.1	14.3±5.1	0.882
合并症[例（%）]
2型糖尿病	12（40）	9（45）	12（60）	0.128
GERD	9（25.7）	10（35.7）	12（37.5）	0.719
OSAHS	11（36.6）	13（60）	11（55）	0.728
GERD-Q（分，±s）	9.81±1.28	9.51±0.98	10.11±1.08	0.619

表1 3组患者一般资料比较

指标	SG组（35例）	OAGB组（28例）	SASI组（32例）	P值
年龄（岁，±s）	27.05±7.6	33.6±5.3	34.9±6.8	0.203
性别（男性/女性）	19/16	15/13	17/15	0.312
BMI（kg/m²，±s）	34.7±6.2	39.5±4.9	38.2±5.8	0.214
体质量（kg，±s）	107.7±23.8	102.8±17.3	105.5±18	0.059
腰围（cm，±s）	118.0±12.9	115.0±10.7	116.8±11.2	0.187
臀围（cm，±s）	110.8±7.3	112.6±6.3	108.7±8.9	0.317
糖化血红蛋白（%，±s）	6.0±1.2	5.9±2.4	6.9±2.3	0.235
血红蛋白（g/L，±s）	129.4±8.6	117.9±7.1	126.7±19.1	0.187
空腹血糖（mmol/L，±s）	6.2±2.1	7.1±2.2	7.2±2.9	0.218
白蛋白（g/L，±s）	41.5±3.5	41.8±3.4	44.5±4.6	0.282
甘油三酯（mmol/L，±s）	2.1±2.2	2.0±1.2	2.3±1.9	0.201
维生素B12（pg/ml，±s）	493.5±188.1	490.1±221.9	513.3±273.5	0.264
25羟基维生素D（±s）	15.2±4.3	13.1±7.1	14.3±5.1	0.882
合并症[例（%）]
2型糖尿病	12（40）	9（45）	12（60）	0.128
GERD	9（25.7）	10（35.7）	12（37.5）	0.719
OSAHS	11（36.6）	13（60）	11（55）	0.728
GERD-Q（分，±s）	9.81±1.28	9.51±0.98	10.11±1.08	0.619

表2 3组患者术后临床指标比较[例(%)]

组别	例数	呕吐	反酸	腹泻	胃绞痛	腹胀
SG组	35	20（57.1）	24（68.6）	8（22.9）	7（20）	14（40）
OAGB组	28	11（39.3）	10（35.7）	8（28.6）	9（32.1）	3（10.7）
SASI组	32	5（15.6）	3（9.3）	10（31.3）	5（15.6）	2（6.3）
P值		0.001	0.007	0.002	0.008	0.213

表2 3组患者术后临床指标比较[例(%)]

组别	例数	呕吐	反酸	腹泻	胃绞痛	腹胀
SG组	35	20（57.1）	24（68.6）	8（22.9）	7（20）	14（40）
OAGB组	28	11（39.3）	10（35.7）	8（28.6）	9（32.1）	3（10.7）
SASI组	32	5（15.6）	3（9.3）	10（31.3）	5（15.6）	2（6.3）
P值		0.001	0.007	0.002	0.008	0.213

表3 3组患者术后体质量及胃食管反流恢复情况比较（

±s）

指标	SG组（35例）	OAGB组（28例）	SASI组（32例）	P值
体质量（kg）
术前	107.7±23.8	102.8±17.3	105.5±18.0	0.059
术后6个月	81.03±11.1	84.13±12.7	79.32±11.2	0.012
术后12个月	71±12.3	73.2±10.1	70.1±9.3	0.003
BMI（kg/m²）
术前	34.7±6.2	39.5±4.9	38.2±5.8	0.214
术后6个月	30.9±5.3	32.1±3.7	28.4±4.5	0.009
术后12个月	22.0±3.2	25.9±4.1	21.3±2.8	0.002
%TWL
术后6个月	21.4±2.7	19.3±2.2	17.87±4.2	0.006
术后12个月	27.4±4.2	25.2±3.3	27.83±5.3	0.045
%EBMIL
术后6个月	62.3±31.08	52.2±12.1	63.1±37.1	0.004
术后12个月	81.1±29.3	75.09±24.9	84.3±17.9	0.019
GERD-Q（分）
术前	9.8±1.3	9.51±1.0	10.1±1.1	0.619
术后6个月	8.3±1.3	7.2±0.9	6.8±1.2	0.004
术后12个月	7.8±1.2	5.3±1.0	5.3±1.0	0.001

表3 3组患者术后体质量及胃食管反流恢复情况比较（

±s）

指标	SG组（35例）	OAGB组（28例）	SASI组（32例）	P值
体质量（kg）
术前	107.7±23.8	102.8±17.3	105.5±18.0	0.059
术后6个月	81.03±11.1	84.13±12.7	79.32±11.2	0.012
术后12个月	71±12.3	73.2±10.1	70.1±9.3	0.003
BMI（kg/m²）
术前	34.7±6.2	39.5±4.9	38.2±5.8	0.214
术后6个月	30.9±5.3	32.1±3.7	28.4±4.5	0.009
术后12个月	22.0±3.2	25.9±4.1	21.3±2.8	0.002
%TWL
术后6个月	21.4±2.7	19.3±2.2	17.87±4.2	0.006
术后12个月	27.4±4.2	25.2±3.3	27.83±5.3	0.045
%EBMIL
术后6个月	62.3±31.08	52.2±12.1	63.1±37.1	0.004
术后12个月	81.1±29.3	75.09±24.9	84.3±17.9	0.019
GERD-Q（分）
术前	9.8±1.3	9.51±1.0	10.1±1.1	0.619
术后6个月	8.3±1.3	7.2±0.9	6.8±1.2	0.004
术后12个月	7.8±1.2	5.3±1.0	5.3±1.0	0.001

1	Perdomo CM, Cohen RV, Sumithran P, et al. Contemporary medical, device, and surgical therapies for obesity in adults[J]. Lancet (London, England), 2023, 401(10382): 1116-1130.
2	Kloock S, Ziegler CG, Dischinger U. Obesity and its comorbidities, current treatment options and future perspectives: challenging bariatric surgery?[J]. Pharmacol Ther, 2023, 251: 108549.
3	Ansari S, Khoo B, Tan T. Targeting the incretin system in obesity and type 2 diabetes mellitus[J]. Nat Rev Endocrinol, 2024, 20(8): 447-459.
4	Bianchettin RG, Lavie CJ, Lopez-Jimenez F. Challenges in cardiovascular evaluation and management of obese patients: JACC State-of-the-Art Review[J]. J Am Coll Cardiol, 2023, 81(5): 490-504.
5	Yuan S, Larsson SC. Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study[J]. Eur J Epidemiol, 2022, 37(7): 747-754.
6	Sugano K, Spechler SJ, EL-Omar EM, et al. Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction[J]. Gut, 2022, 71(8): 1488-1514.
7	Argüero J, Sifrim D. Pathophysiology of gastro-oesophageal reflux disease: implications for diagnosis and management[J]. Nat Rev Gastroenterol Hepatol, 2024, 21(4): 282-293.
8	Fass R, Boeckxstaens GE, EL-Serag H, et al. Gastro-oesophageal reflux disease[J]. Nat Rev Dis Primers, 2021, 7(1): 55.
9	Bennett C, Vakil N, Bergman J, et al. Consensus statements for management of Barrett’s dysplasia and early-stage esophageal adenocarcinoma, based on a Delphi process[J]. Gastroenterology, 2012, 143(2): 336-346.
10	Boeckxstaens G, EL-Serag HB, Smout AJPM, et al. Symptomatic reflux disease: the present, the past and the future[J]. Gut, 2014, 63(7): 1185-1193.
11	EL-Serag HB, Hashmi A, Garcia J, et al. Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett’s oesophagus: a case-control study[J]. Gut, 2014, 63(2): 220-229.
12	Duggan C, Onstad L, Hardikar S, et al. Association between markers of obesity and progression from Barrett’s esophagus to esophageal adenocarcinoma[J]. Clin Gastroenterol Hepatol, 2013, 11(8): 934-943.
13	Hampel H, Abraham NS, EL-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications[J]. Ann Intern Med, 2005, 143(3): 199-211.
14	Salminen P, Grönroos S, Helmiö M, et al. Effect of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass on weight loss, comorbidities, and reflux at 10 years in adult patients with obesity: the SLEEVEPASS randomized clinical trial[J]. JAMA Surg, 2022, 157(8): 656-666.
15	Singh B, Saikaustubh Y, Singla V, et al. One anastomosis gastric bypass (OAGB) vs Roux en Y gastric bypass (RYGB) for remission of T2DM in patients with morbid obesity: a randomized controlled trial[J]. Obes Surg, 2023, 33(4): 1218-1227.
16	Yu H, Qian L, Yan Y, et al. Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass, and single-anastomosis sleeve ileal bypass in the treatment of metabolic syndrome[J]. Sci Rep, 2024, 14(1): 5069.
17	Du Y, Zhang J, Chen G, et al. Formulation and interpretation of the Chinese guidelines for surgical treatment of obesity and type 2 diabetes mellitus[J]. Biosci Trends, 2021, 15(5): 299-304.
18	Felsenreich DM, Arnoldner MA, Wintersteller L, et al. Intrathoracic pouch migration in one-anastomosis gastric bypass with and without hiatoplasty: a 3-dimensional-computed tomography volumetry study[J]. Surg Obes Relat Dis, 2023, 19(5): 492-499.
19	Nickel F, Schmidt L, Bruckner T, et al. Influence of bariatric surgery on quality of life, body image, and general self-efficacy within 6 and 24 months-a prospective cohort study[J]. Surg Obes Relat Dis, 2017, 13(2): 313-319.
20	Kindel TL, Oleynikov D. The improvement of gastroesophageal reflux disease and Barrett’s after bariatric surgery[J]. Obes Surg, 2016, 26(4): 718-720.
21	Santoro S, Castro LC, Velhote MCP, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity[J]. Ann Surg, 2012, 256(1): 104-110.
22	Arterburn DE, Johnson E, Coleman KJ, et al. Weight outcomes of sleeve gastrectomy and gastric bypass compared to nonsurgical treatment[J]. Ann Surg, 2021, 274(6): e1269-e1276.
23	Gentileschi P, Siragusa L, Alicata F, et al. Nutritional status after Roux-En-Y (Rygb) and one anastomosis gastric bypass (Oagb) at 6-month follow-up: a comparative study[J]. Nutrients, 2022, 14(14): 2823.
24	Burgerhart JS, Schotborgh CAI, Schoon EJ, et al. Effect of sleeve gastrectomy on gastroesophageal reflux[J]. Obes Surg, 2014, 24(9): 1436-1441.
25	Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy[J]. Surg Obes Relat Dis, 2016, 12(10): 1778-1786.
26	Rebecchi F, Allaix ME, Giaccone C, et al. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation[J]. Ann Surg, 2014, 260(5): 909-914; discussion 914-915.
27	Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy[J]. Surg Obes Relat Dis, 2016, 12(4): 750-756.
28	De Luca M, Angrisani L, Himpens J, et al. Indications for surgery for obesity and weight-related diseases: position statements from the international federation for the surgery of obesity and metabolic disorders (IFSO)[J]. Obes Surg, 2016, 26(8): 1659-1696.
29	Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease[J]. Am J Gastroenterol, 2013, 108(3): 308-328; quiz 329.
30	Salman MA, Abelsalam A, Nashed GA, et al. Long biliopancreatic limb Roux-En-Y gastric bypass versus one-anastomosis gastric bypass: a randomized controlled study[J]. Obes Surg, 2023, 33(7): 1966-1973.
31	Parkitna J, Jaworski P, Binda A, et al. Effect of SASI procedure (Single Anastomosis Sleeve Ileal) on the symptoms of gastroesophageal reflux disease in bariatric patients—a review of the literature[J]. Pol Przegl Chir, 2023, 96(0): 60-64.
32	Khalaf M, Hamed H. Single-anastomosis sleeve ileal (SASI) bypass: hopes and concerns after a two-year follow-up[J]. Obes Surg, 2021, 31(2): 667-674.
33	Emile SH, Madyan A, Mahdy T, et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study[J]. Surg Endosc, 2021, 35(2): 652-660.

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Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass and single anastomosis sleeve ileal in the treatment of obesity combined with gastroesophageal reflux disease

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Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass and single anastomosis sleeve ileal in the treatment of obesity combined with gastroesophageal reflux disease