Abstract：
Gastroesophageal reflux disease (GERD) is a significant complication of sleeve gastrectomy (SG). Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is considered the primary treatment for bariatric surgery candidates with GERD. Post-operative options for GERD management are limited. This study compares the effect of transoral fundoplication (TF) prior to SG vs LRYGB in patients with GERD .
Of 30 consecutive bariatric surgery patients with GERD between 3/22/2018 and 6/23/2020, 15 patients underwent TF prior to SG (TF/SG) and 15 patients underwent LRYGB. Subjective and objective criteria, including the GERD Health-Related Quality of Life (HRQL) and Reflux Symptom Index (RSI) survey, were used to assess symptoms. Surveys were collected pre-operatively, post-TF/pre-SG, 4-6 and 12-15 months post bariatric procedure.
Preoperative mean scores were as follows: HRQL 32.53, RSI 21.7, 93% proton pump inhibitor (PPI) usage, 6.5% satisfaction rate. Mean BMI: 45.99 (TF/SG), 42.27 (LRYGB). At 12-15 months postoperatively: mean HRQL scores were 5.53 (TF/SG) and 6.67 (LRYGB). Both groups had a statistically significant improvement in HRQL-RSI postoperatively. PPI usage was 13% (TF/SG) and 34% (LRYGB). BMI decrease was 24% (TF/SG) and 31% (LRYGB).
TF/SG is at least equivalent to LRYGB in resolution or reduction of reflux symptoms at 12-15 months.
Of 30 consecutive bariatric surgery patients with GERD between 3/22/2018 and 6/23/2020, 15 patients underwent TF prior to SG (TF/SG) and 15 patients underwent LRYGB. Subjective and objective criteria, including the GERD Health-Related Quality of Life (HRQL) and Reflux Symptom Index (RSI) survey, were used to assess symptoms. Surveys were collected pre-operatively, post-TF/pre-SG, 4-6 and 12-15 months post bariatric procedure.
Preoperative mean scores were as follows: HRQL 32.53, RSI 21.7, 93% proton pump inhibitor (PPI) usage, 6.5% satisfaction rate. Mean BMI: 45.99 (TF/SG), 42.27 (LRYGB). At 12-15 months postoperatively: mean HRQL scores were 5.53 (TF/SG) and 6.67 (LRYGB). Both groups had a statistically significant improvement in HRQL-RSI postoperatively. PPI usage was 13% (TF/SG) and 34% (LRYGB). BMI decrease was 24% (TF/SG) and 31% (LRYGB).
TF/SG is at least equivalent to LRYGB in resolution or reduction of reflux symptoms at 12-15 months.
摘要：
背景：胃食管反流病（GERD）是袖状胃切除术（SG）的重要并发症。腹腔镜Roux-en-Y胃旁路术（LRYGB）被认为是患有GERD的减肥手术候选人的主要治疗方法。GERD的术后管理选择有限。这项研究比较了GERD患者在SG和LRYGB之前经口胃底折叠（TF）的效果。
方法：在2018年3月22日至2020年6月23日期间连续30例GERD减重手术患者中，15例患者在SG之前接受TF（TF/SG），15例患者接受LRYGB。主观和客观标准，包括GERD健康相关生活质量(HRQL)和反流症状指数(RSI)调查，用于评估症状。术前收集调查，post-TF/pre-SG,减重手术后4-6个月和12-15个月。
结果：术前平均评分如下：HRQL32.53，RSI21.7，93%质子泵抑制剂（PPI）的使用，6.5%的满意率。平均BMI：45.99（TF/SG），42.27(LRYGB)。术后12-15个月：平均HRQL评分分别为5.53（TF/SG）和6.67（LRYGB）。两组术后HRQL-RSI均有统计学意义的改善。PPI使用率分别为13%（TF/SG）和34%（LRYGB）。BMI下降24%(TF/SG)和31%(LRYGB)。
结论：TF/SG在缓解或减轻12-15个月时的反流症状方面至少等同于LRYGB。
方法：在2018年3月22日至2020年6月23日期间连续30例GERD减重手术患者中，15例患者在SG之前接受TF（TF/SG），15例患者接受LRYGB。主观和客观标准，包括GERD健康相关生活质量(HRQL)和反流症状指数(RSI)调查，用于评估症状。术前收集调查，post-TF/pre-SG,减重手术后4-6个月和12-15个月。
结果：术前平均评分如下：HRQL32.53，RSI21.7，93%质子泵抑制剂（PPI）的使用，6.5%的满意率。平均BMI：45.99（TF/SG），42.27(LRYGB)。术后12-15个月：平均HRQL评分分别为5.53（TF/SG）和6.67（LRYGB）。两组术后HRQL-RSI均有统计学意义的改善。PPI使用率分别为13%（TF/SG）和34%（LRYGB）。BMI下降24%(TF/SG)和31%(LRYGB)。
结论：TF/SG在缓解或减轻12-15个月时的反流症状方面至少等同于LRYGB。
