巴雷特的食道在减肥手术:回归还是进展?
Yusef Moulla1, Haitham Hamadeh2, Lena Seidemann3
1Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, 04103, Leipzig, Germany. yusef.moulla@medizin.uni-leipzig.de.
Obesity surgery
|September 30, 2023
概括
腹腔外科手术对肥胖患者的巴雷特食道 (BE) 有影响. 腹腔镜Roux-en-Y-胃绕道 (LRYGB) 在35%的患者中显示出BE回归,而腹腔镜袖子胃切除术 (LSG) 在30%的患者中显示出进展.
科学领域:
- 胃肠病学 胃肠病学
- 腹部外科 腹部外科
- 在瘤学瘤学.
背景情况:
- 致病性肥胖是胃食道逆流性疾病 (GERD) 和其后果,包括巴雷特食道 (BE) 的重要危险因素.
- 减肥手术越来越多地在肥胖个体中进行,因此需要了解其对像BE.BE这样的GERD相关疾病的影响.
研究的目的:
- 评估巴雷特食道 (Barrett's esophagus,BE) 在减肥手术后患者的发展和进展.
- 为了比较不同减肥外科手术程序对BE的影响.
主要方法:
- 对从2012年到2019年间接受了减肥手术的肥胖患者的前性数据库进行了回顾性分析.
- 使用布拉格分类和英国组织学评估指南,比较手术前内镜检测结果和手术后1-2年和3-5年内镜检测结果.
主要成果:
- 在914名患者中,有119名 (13%) 患有手术前的B.E. 74名患者进行了随访内镜检查.
- 在 laparoscopic Roux-en-Y-胃旁路术 (LRYGB) 后,巴雷特食道回归发生在35%的患者 (19/54) 中.
- 在腹腔镜袖胃切除术 (LSG) 后,巴雷特食道进展在30%的患者 (6/20) 中观察到.
结论:
- 减肥手术的类型显著影响巴雷特食道的变化.
- 与腹腔镜袖子胃切除术 (LSG) 相比, laparoscopic Roux-en-Y-胃绕道 (LRYGB) 在实现BE回归方面似乎更有效.
- 术前检测BE对于指导减肥手术的选择至关重要,以优化患者的结果.
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