The Treatment Of 30 Patients With Obesity And Gastroesophageal Reflux Disease Treated By Laparoscopic Fundoplication Combined With Sleeve Gastrectomy

Objective: Objective to investigate the feasibility,safety and efficacy of laparoscopic gastric sleeve resection combined with partial fundoplication in the treatment of obesity complicated with gastroesophageal reflux disease,and to explore whether it is a new surgical treatment option for obesity and GERD.Methods: Methods a retrospective analysis of 30 patients with obesity and GERD who underwent laparoscopic fundoplication combined with sleeve gastrectomy from 2014 to 2017 2014 in the Xinjiang Uygur Autonomous Region people's Hospital minimally invasive surgery was performed.And the follow-up was 1,3 and 6 months after the operation.The effects of postoperative weight loss on patients with GERD symptoms and obesity related metabolic diseases were monitored.Results: The subjects of this study included 14 men and 16 women.The average age of the patients was 37.1 years(from 22~54).The average body weight of the patients before operation was 107.98 + 18.42 kg,and the average body weight of 6 months after operation was 80.12 + 13.50 kg.The average BMI was 37.14 + 4.25 kg/m2 before treatment,and the average BMI was 28.26 + 5.14 kg/m2 after 6 months of treatment.The mean systolic pressure was 178.98 + 18.15 mmHg before treatment,and the mean systolic pressure was 140.64 + 16.34 mmHg after 6 months of treatment.The average diastolic pressure was 97.28 + 15.26 mmHg before treatment,and the average diastolic pressure of6 months after treatment was 79.35 + 13.02 mmHg.The average triglyceride was 7.98 +1.36 mmol/l before treatment,and the mean triglyceride was 3.89 + 3.24 mmol/l at 6months after treatment.The average fasting blood glucose before treatment was 9.68 +1.64 mmol/l,and the mean fasting blood glucose was 5.94 5.94 mmol/l after 6 months treatment.The average waist circumference was 118.27 + 8.02 cm before treatment,and the average waist circumference was 86.25 + 10.22 cm after 6 months of treatment.The average hip circumference was 120.34 + 8.34 cm before treatment,and the average hip circumference was 84.67 + 7.68 cm after 6 months of treatment.The average GERDQ score was 9.79 + 1.32 points before treatment,and the average GERDQ score of 6 months after treatment was 5.04 + 1.21 points,Compared with before treatment,the difference of data was statistically significant(P<0.05).Conclusion:Laparoscopic fundoplication combined with gastric sleeve resection in the treatment of obese patients with gastroesophageal reflux disease is feasible,safe,effective operation mode,is a kind of treatment of obesity with GERD or hiatal hernia provides new anti reflux bariatric surgery method in clinical practice,but the long-term effect remains to be observed,keep the number of gastric fundus,what kind of folding selection techniques and other key operation standardization need to conscientiously sum up experiences and reasonable evidencebased research.