袖子胃切除术患者的术后结果,这些患者具有阳性pH定义的GERD
Ila Sethi1, Aidan Aicher2, Fareed Cheema3
1Division of Bariatric, Foregut, and Advanced GI Surgery, Department of Surgery, Stony Brook University Hospital, 101 Nicolls Road, Stony Brook, NY, 11790, USA. Ila.sethi@stonybrookmedicine.edu.
Surgical endoscopy
|June 13, 2023
概括
手术前的pH测试可以确定在袖子胃切除术 (SG) 后患转化手术风险较高的患者. 对于那些有轻度症状和阴性pH测试的人来说,SG可能是一个持久的减肥手术选择.
科学领域:
- 腹腔外科手术的结果
- 胃肠病学 胃肠病学
- 手术方面的创新.
背景情况:
- 胃食道逆流性疾病 (GERD) 是经过袖子胃切除术 (SG) 的已知潜在并发症.
- 为减肥手术选择患者,特别是那些有先前存在的GERD患者,由于复杂的风险因素和关于症状恶化的不一致文献,提出了挑战.
- 准确的手术前评估对于优化手术结果和患者生活质量至关重要.
研究的目的:
- 通过客观的pH测试,评估袖子胃切除术 (SG) 对被诊断患有手术前胃食道逆流病 (GERD) 的患者的影响.
- 为了确定不良结果的预测因素,如转换手术的需要,在接受SG的患者中,先前存在的GERD.
- 评估SG后胃肠道生活质量 (GIQLI) 与GERD状态相关的变化.
主要方法:
- 一个单一中心的病例系列,比较了手术前GERD和没有GERD的SG患者,通过pH测试证实了这一点.
- 对手术前的人口统计,内镜检查结果,转换手术的需要和GIQLI分数的分析.
- 使用两个样本独立的t测试进行统计比较,以确定GERD阳性和GERD阴性队列之间的显著差异.
主要成果:
- 20名SG患者接受了手术前的pH测试;9人呈GERD阳性 (DeMeester评分为26.7),11人呈GERD阴性 (DeMeester评分为9.0).
- 两组之间没有观察到BMI,内镜检查结果或GERD药物使用的显著差异.
- 两名GERD阳性患者 (22%) 需要转换为胃绕道,而没有任何GERD阴性患者;然而,手术后的GIQLI得分和反流症状在两组中都相似.
结论:
- 客观的pH测试可以帮助区分患有GERD的患者,这些患者在SG后可能面临更高的胃绕道转换风险.
- 袖子胃切除术 (SG) 可能是轻度GERD症状但pH测试阴性患者的可行和持久的选择.
- 进一步的研究是有必要的,以完善患者选择的标准,在GERD的背景下减肥手术.
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