Application of laparoscopic sleeve gastrectomy combined with esophageal hiatal hernia repair in the treatment of obesity combined with gastroesophageal reflux disease

doi:10.3877/ cma.j.issn.2095-8765.2020.01.004

Abstract

Abstract:

Objective

To analyze the application of weight loss and anti-reflux outcomes of laparoscopic sleeve gastrectomy (LSG) with esophageal hiatal hernia repair(HHR) method in the treatment of obesity combined with gastroesophageal reflux disease(GERD).

Methods

A retrospective analyze was made on 43 obese with GERD who underwent LSG combined with HHR treatment from January 2017 to January 2019 in the our hospital were collected as a study group. We recorded the clinical data, including： body weight, BMI, excess weight loss rate(EWL), waist circumference, GerdQ, acid reflux time, acid reflux number, LES resting pressure, DeMeester score；analyzed the above data before and after surgery, and follow up for 6 to 12 month.

Results

After surgery, body weight decreased from (123.2±17.0) kg to (89.1±13.5) kg, BMI decreased from (42.3±6.2) kg/m² to (30.6±5.2) kg/m², waist circumference decreased from (129.7±13.3) cm to (102.3±9.8) cm, the difference was statistically significant (P＜0.05), EWL is 65.8±15.7%; acid reflux time decreased from (182.8±118.5) min to (105.2±62.4) min, acid reflux number decreased from (103.7±70.4) to (30.5±12.2), LES resting pressure increased from (17.0±14.2) mmHg to (30.1±14.9) mmHg, DeMeester score decreased from (24.2±18.2) to (9.7±4.1), GERD-Q decreased from (11.5±1.8) to (7.4±1.0), the difference were statistically significant (P＜0.05)；

Conclusion

The short-term efficacy of LSG with HHR in the treatment of obese with GERD was clear, safe, reliable, and feasible. It can not only effectively reduce weight but also improve GERD ocurrence. Its long-term efficacy needs further investigation.

Key words: Laparoscopic sleeve gastrectomy, Hiatal hernia repair, Obesity, Gastroesophageal reflux disease, Efficacy

Aikebaier·Aili, Pierdiwasi·Maimaitiyusufu, Ababokeli·Wusiman, Maimaiti·Yisireyili, Saifuding·Aibibula, Liyiliang, Yibitihaer·Maimaitiaili, Jiangyuan, Saimi·Saimaiti, Kelimu·Abudureyimu. Application of laparoscopic sleeve gastrectomy combined with esophageal hiatal hernia repair in the treatment of obesity combined with gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2020, 07(01): 41-45.

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References 32

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时间	体重（kg）	BMI（kg/m²）	腹围（cm）	EWL（%）
术前	123.2±17.0	42.3±6.2	129.7±13.3
术后	89.1±13.5	30.6±5.2	102.3±9.8	65.8±15.7
t 值	22.531	23.331	24.623
P 值	＜0.001	＜0.001	＜0.001

时间	体重（kg）	BMI（kg/m²）	腹围（cm）	EWL（%）
术前	123.2±17.0	42.3±6.2	129.7±13.3
术后	89.1±13.5	30.6±5.2	102.3±9.8	65.8±15.7
t 值	22.531	23.331	24.623
P 值	＜0.001	＜0.001	＜0.001

时间	反流次数 /（次）	反流时间 /（min）	LESRP （mmHg）	DeMeester 评分	Gerd 评分
术前	103.7±70.4	182.8±118.5	17.0±14.2	24.2±18.2	11.5±1.8
术后	30.5±12.2	105.2±62.5	30.1±14.9	11.1±6.0	7.4±1.0
t 值	8.447	8.226	-17.259	6.142	14.788
P 值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

时间	反流次数 /（次）	反流时间 /（min）	LESRP （mmHg）	DeMeester 评分	Gerd 评分
术前	103.7±70.4	182.8±118.5	17.0±14.2	24.2±18.2	11.5±1.8
术后	30.5±12.2	105.2±62.5	30.1±14.9	11.1±6.0	7.4±1.0
t 值	8.447	8.226	-17.259	6.142	14.788
P 值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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