GERD症状和内镜RE对LSG后早期术后GERD的影响
Genzheng Liu1,2, Shuman Ran2,3, Yuntao Nie2
1China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Obesity surgery
|October 2, 2025
概括
手术前的GERD症状和洛杉矶 (LA) 分类是 laparoscopic袖子胃切除术 (LSG) 后发展GERD的关键预测因素. 这些因素的早期识别和管理可以帮助减轻风险.
科学领域:
- 腹部外科 腹部外科
- 胃肠病学 胃肠病学
- 外科手术的结果
背景情况:
- laparoscopic 袖子胃切除术 (LSG) 可以使现有的胃食道逆流病 (GERD) 恶化或引起新的胃食道逆流病 (GERD).
- 术前GERD诊断是已知的风险因素,但各种评估方法的预测能力需要澄清.
研究的目的:
- 评估手术前GERD-Q分数和洛杉矶 (LA) 分类对LSG后早期术后GERD症状的影响.
- 确定这些方法对术后GERD的个别和综合预测价值.
主要方法:
- 对从371名接受LSG的肥胖患者前性收集的数据进行了回顾性分析.
- 通过GERD-Q评分 (≥8) 和内镜 (LA分类) 评估的手术前GERD症状.
- 经手术后的GERD症状在一年内进行监测.
主要成果:
- 24.53%的患者在LSG后发展出GERD,累积发病率随着时间的推移而增加.
- 手术前的GERD症状 (HR=1.88) 和更高的LA等级 (LA-A:HR=2.83;LA-B/C:HR=3.05) 是独立的风险因素.
- 综合症状和内镜评估显示,内镜阳性,GERD-Q阳性和双阳性组存在显著风险.
结论:
- 手术后的GERD发病率在LSG后持续上升.
- 手术前GERD-Q阳性和LA等级 (A,B/C) 是GERD后LSG的重要独立风险因素.
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