Scholarlink

Objective <p>While laparoscopic sleeve gastrectomy (LSG) is an established bariatric procedure for obesity, postoperative gastroesophageal reflux disease (GERD) remains a significant complication. This study evaluates the short-term efficacy of a novel technique combining LSG with acute angle of His reconstruction (LSG-His) versus conventional LSG.</p> Methods <p>This is a single center retrospective observation cohort study. Among 83 patients undergoing bariatric surgery, 39 receiving conventional LSG and 44 undergoing LSG-His (with diaphragmatic fundopexy using 2-0 Prolene sutures) were analyzed. GERD symptoms were assessed using the Reflux Diagnostic Questionnaire (RD-Q) and GERD Questionnaire (GERD-Q) at baseline and at 3-, 6-, 12-, 24-month postoperatively. Weight loss outcomes included percentage of excess weight loss (%EWL) and total weight loss.</p> Results <p>Postoperative follow-up showed a sustained reduction in GERD symptoms for the LSG-His group across all time points using both scoring systems (all p&lt;0.001 vs LSG). The results demonstrated that, when assessed using the GERD-Q at the 24-month follow-up, the prevalence of GERD symptoms was 14% (95% CI: 6.3% - 25.7%) among LSG-His patients versus 46% (95% CI: 32.1% - 60.7%) among LSG patients (p&lt;0.001). As evaluated via the RD-Q at the same 24-month follow-up, GERD symptom prevalence was 7% (95% CI: 2.3%- 17.9%) in the LSG-His group compared with 41% (95% CI: 27.3% - 56.3%) in the LSG group (p&lt;0.001).%EWL was higher in the LSG-His group at 3 months (54.7% vs 46.5%, p=0.033), 6 months (73.8% vs 64%, p=0.047), 12 months (82.9% vs 72.2%, p=0.042) and 24 months (84.1% vs 75.4%, p=0.038) follow-up compared to LSG group.</p> Conclusion <p>In this retrospective observational study, LSG-His was associated with lower rates of GERD symptoms and higher %EWL compared to standard LSG, but with comparable %TWL in 24 month outcomes. However, these preliminary results are limited to short-term follow-up, and long-term prospective studies with objective reflux assessment are warranted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The short-term effect of laparoscopic sleeve gastrectomy with his angle reconstruction (LSG-His) on gastroesophageal reflux disease

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月21日

查看全文
  • Ke Cao,
  • Zhiwei Zhai,
  • Xuyin Shi,
  • Yin Jin,
  • Chunxiang Ye,
  • Yunlong Wu,
  • Mingyu Sun,
  • Jing Wang,
  • Zhenjun Wang,
  • Jiagang Han

摘要

Objective

While laparoscopic sleeve gastrectomy (LSG) is an established bariatric procedure for obesity, postoperative gastroesophageal reflux disease (GERD) remains a significant complication. This study evaluates the short-term efficacy of a novel technique combining LSG with acute angle of His reconstruction (LSG-His) versus conventional LSG.

Methods

This is a single center retrospective observation cohort study. Among 83 patients undergoing bariatric surgery, 39 receiving conventional LSG and 44 undergoing LSG-His (with diaphragmatic fundopexy using 2-0 Prolene sutures) were analyzed. GERD symptoms were assessed using the Reflux Diagnostic Questionnaire (RD-Q) and GERD Questionnaire (GERD-Q) at baseline and at 3-, 6-, 12-, 24-month postoperatively. Weight loss outcomes included percentage of excess weight loss (%EWL) and total weight loss.

Results

Postoperative follow-up showed a sustained reduction in GERD symptoms for the LSG-His group across all time points using both scoring systems (all p<0.001 vs LSG). The results demonstrated that, when assessed using the GERD-Q at the 24-month follow-up, the prevalence of GERD symptoms was 14% (95% CI: 6.3% - 25.7%) among LSG-His patients versus 46% (95% CI: 32.1% - 60.7%) among LSG patients (p<0.001). As evaluated via the RD-Q at the same 24-month follow-up, GERD symptom prevalence was 7% (95% CI: 2.3%- 17.9%) in the LSG-His group compared with 41% (95% CI: 27.3% - 56.3%) in the LSG group (p<0.001).%EWL was higher in the LSG-His group at 3 months (54.7% vs 46.5%, p=0.033), 6 months (73.8% vs 64%, p=0.047), 12 months (82.9% vs 72.2%, p=0.042) and 24 months (84.1% vs 75.4%, p=0.038) follow-up compared to LSG group.

Conclusion

In this retrospective observational study, LSG-His was associated with lower rates of GERD symptoms and higher %EWL compared to standard LSG, but with comparable %TWL in 24 month outcomes. However, these preliminary results are limited to short-term follow-up, and long-term prospective studies with objective reflux assessment are warranted.