LSG对肥胖合并Ⅰ型食管裂孔疝病人术后胃食管反流病的影响

doi:10.16139/j.1007-9610.2026.01.10

摘要/Abstract

摘要：

目的：探讨腹腔镜胃袖状切除术（LSG）对肥胖合并Ⅰ型食管裂孔疝（HH）的病人术后胃食管反流病（GERD）的影响。方法：回顾性分析2023年3月至2024年12月期间收治的肥胖病人63例，分为A组单纯肥胖组（n=50）与B组肥胖合并Ⅰ型HH（n=13）。两组均采取SG手术方式，B组术中未行同期HH修补。通过GERD问卷(Gerd-Q)评分评估术前及术后3、6个月的反流症状，并比较组间差异。结果：两组间术前及术后3、6个月Gerd-Q评分比较差异均无统计学意义（均P>0.05）。两组术后3、6个月分别与术前Gerd-Q评分比较差异均无统计学意义（P>0.05）。两组间术前及术后3、6个月时GERD患病率比较差异均无统计学意义（均P>0.05）。结论：对于肥胖合并Ⅰ型HH的病人，行LSG并没有增加术后GERD的发生率。

关键词: 腹腔镜胃袖状切除术, 食管裂孔疝, 胃食管反流病, 胃食管反流病问卷

Abstract:

Objective To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) after surgery in obese patients with type Ⅰ hiatal hernia (HH). Methods A retrospective analysis was conducted on 63 obese patients admitted between March 2023 and December 2024. The patients were divided into two groups: group A, simple obesity (n=50), and group B, obesity with type ⅠHH (n=13). Both groups underwent SG, and no concurrent HH repair was performed in Group B. Gerd-Q scores were used to evaluate reflux symptoms preoperatively and at 3 and 6 months postoperatively, and the differences between the groups were compared. Results There was no significant difference in the Gerd-Q scores between the two groups before surgery and 3, 6 months after surgery (all P>0.05). When comparing the Gerd-Q scores of the two groups of patients at 3, 6 months after surgery with those before surgery, there were no significant differences (P>0.05). There was no significant difference in the prevalence of GERD between the two groups before surgery and 3, 6 months after surgery (all P>0.05). Conclusions For obese patients with type ⅠHH, undergoing LSG did not increase the incidence of postoperative GERD.

Key words: Laparoscopic sleeve gastrectomy(LSG), Hiatal hernia(HH), Gastroesophageal reflux disease(GERD), Gerd-Q

中图分类号:

孙武青, 郭震, 姬阆, 郝少龙, 孙海涛, 白日星, 韩威. LSG对肥胖合并Ⅰ型食管裂孔疝病人术后胃食管反流病的影响[J]. 外科理论与实践, 2026, 31(01): 58-63.

SUN Wuqing, GUO Zhen, JI Lang, HAO Shaolong, SUN Haitao, BAI Rixing, HAN Wei. Impact of laparoscopic sleeve gastrectomy on gastroesophageal reflux disease in patients with obesity and type Ⅰ hiatal hernia[J]. Journal of Surgery Concepts & Practice, 2026, 31(01): 58-63.

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Characteristics	Group A （n=50）	Group B （n=13）	statistical value	P value
Gender（Male/female）	21/29	7/6	χ²=0.029	0.864
Age（year）	34.0±9.8	33.3±9.6	t=0.289	0.773
Length of stay（day）	6.3±2.1	7.4±2.3	t=0.182	0.768

Time	Group A （n=50）	Group B （n=13）	t value	P value
Preoperative	40.6±5.9	41.5±3.8	-0.727	0.473
Postoperative month 1	35.7±5.4	36.6±3.0	-0.822	0.417
Postoperative month 3	32.4±5.4	32.8±3.5	-0.358	0.723
Postoperative month 6	29.6±4.8	30.3±3.6	-0.515	0.611

Time	Group A （n=50）	Group B （n=13）	t value	P value
Postoperative month 1	12.0±5.0	11.8±3.2	0.191	0.850
Postoperative month 3	20.2±6.1	21.0±5.1	-0.476	0.639
Postoperative month 6	26.8±6.9	27.2±5.5	-0.195	0.847

Time	Group A （n=50）	Group B （n=13）	t value	P value
Postoperative month 1	27.8±11.9	26.1±7.0	0.658	0.515
Postoperative month 3	47.5±17.0	47.1±12.2	0.091	0.928
Postoperative month 6	62.6±19.0	61.0±13.3	0.352	0.728

Time	Group A （n=50）	Group B （n=13）	t value	P value
Preoperative	6.7±2.9	7.2±2.5	-0.563	0.579
Postoperative month 3	6.3±3.0^a)	7.9±2.7^a)	-1.849	0.079
Postoperative month 6	6.1±2.5^a)	7.4±1.9^a)	-2.063	0.051