Effect of sleeve gastrectomy combined with crura of diaphragm plasticity on gastroesophageal reflux disease after sleeve gastrectomy

doi:10.3877/cma.j.issn.2095-8765.2024.01.001

Abstract

Abstract:

Objective

To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) combined with crura of diaphragm plasticity on gastroesophageal reflux disease (GERD) after LSG.

Methods

Clinical data of 33 patients with obesity who underwent LSG or LSG combined with crura of diaphragm plasticity from June 2022 to March 2023 and completed follow-up in time were retrospectively analyzed. Group as surgical method, there were 18 cases in LSG group and 15 cases in LSG combined with crura of diaphragm plasticity group. Perioperative indicators, improvement of obesity and severity of GERD were compared in these two groups.

Results

All procedures were performed via laparoscopic surgery. In LSG group, mean operative time was (97.06±23.28) min, volume of intraoperative blood loss was (34.72±19.59) ml, hospital stay after operation was (3.44±0.78) d. In LSG combined with crura of diaphragm plasticity group, mean operative time was (100.33±14.82) min, volume of intraoperative blood loss was (31.33±5.16) ml, hospital stay after operation was (3.47±0.74) d, with no statistical significance between the two groups (P>0.05). One month after surgery, there was no significant difference in %EWL and %TWL between the two groups (P>0.05). The GERD-Q score of LSG group was (6.89±1.53) points, and that of LSG combined with crura of diaphragm plasticity group was (6.80±1.37) points, with no statistical significance between the two groups (P>0.05). There were 5 patients (27.78%) with GERD-Q score ≥8 points in LSG group, and 4 patients (26.67%) in LSG combined with crura of diaphragm plasticity group, with no statistical significance between the two groups (P>0.05). Six months after surgery, there was no significant difference in %EWL and %TWL between the two groups (P>0.05). The GERD-Q score of LSG group was (6.06±0.24) points, and that of LSG combined with crura of diaphragm plasticity group was (6.40±1.12) points, with no statistical significance between the two groups (P>0.05). There were 0 patients (0.00%) with GERD-Q score ≥8 points in LSG group, and 2 patients (13.33%) in LSG combined with crura of diaphragm plasticity group, with no statistical significance between the two groups (P>0.05).

Conclusion

Compared with LSG, LSG combined with crura of diaphragm plasticity did not prolong operation time, increase surgical complications and affect postoperative rehabilitation, and had no significant effect on GERD after LSG.

Key words: Obesity, Sleeve gastrectomy, Crura of diaphragm plasticity, Gastroesophageal reflux disease

Chongwen Zhan, Jie Wang, Qiwei Shen, Rong Hua, Qiyuan Yao. Effect of sleeve gastrectomy combined with crura of diaphragm plasticity on gastroesophageal reflux disease after sleeve gastrectomy[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(01): 1-5.

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Figures/Tables 4

References 12

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组别	例数	年龄（岁，）	性别（男性/女性）	BMI（kg/m²，）	GERD-Q评分（分，）
LSG组	18	33.06±10.30	4/14	38.49±6.07	6.06±0.24
LSG+膈肌脚塑形组	15	29.33±6.57	4/11	40.29±5.89	6.00±0.00
检验值		1.208	0.088	0.140	0.910
P值		0.236	0.767	0.889	0.370

组别	例数	年龄（岁，）	性别（男性/女性）	BMI（kg/m²，）	GERD-Q评分（分，）
LSG组	18	33.06±10.30	4/14	38.49±6.07	6.06±0.24
LSG+膈肌脚塑形组	15	29.33±6.57	4/11	40.29±5.89	6.00±0.00
检验值		1.208	0.088	0.140	0.910
P值		0.236	0.767	0.889	0.370

组别	例数	手术时间（min）	术中出血量（ml）	术后住院时间（d）
LSG组	18	97.06±23.28	34.72±19.59	3.44±0.78
LSG+膈肌脚塑形组	15	100.33±14.82	31.33±5.16	3.47±0.74
t值		-0.471	0.650	-0.083
P值		0.641	0.521	0.934

组别	例数	手术时间（min）	术中出血量（ml）	术后住院时间（d）
LSG组	18	97.06±23.28	34.72±19.59	3.44±0.78
LSG+膈肌脚塑形组	15	100.33±14.82	31.33±5.16	3.47±0.74
t值		-0.471	0.650	-0.083
P值		0.641	0.521	0.934

组别	例数	%EWL（%，）	%TWL（%，）	GERD-Q评分（分，）	GERD-Q≥8分[例（%）]
LSG组	18	30.14±7.78	10.66±1.70	6.89±1.53	5（27.78）
LSG+膈肌脚塑形组	15	33.40±13.44	10.89±3.55	6.80±1.37	4（26.67）
检验值		-0.872	-0.243	-0.174	0.005
P值		0.390	0.810	0.863	0.943

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