A multicenter retrospective cohort study on factors associated with the occurrence of gastroesophageal reflux disease after sleeve gastrectomy
10.7659/j.issn.1005-6947.240470
- VernacularTitle:胃袖状切除术后胃食管反流病发生的相关因素的多中心回顾性队列研究
- Author:
Jiahao LI
1
;
Xiang GAO
;
Pengzhou LI
;
Zhi SONG
;
Weizheng LI
;
Lei ZHAO
;
Youwu WEN
;
Henggui LUO
;
Tongli YUAN
;
Zhen LI
;
Liyong ZHU
Author Information
1. 中南大学湘雅三医院 胃肠疝与减重代谢外科,湖南 长沙 410013
- Publication Type:Journal Article
- Keywords:
Bariatric Surgery;
Gastrectomy;
Gastroesophageal Reflux;
Risk Factors;
Esophagogastric Junction
- From:
Chinese Journal of General Surgery
2025;34(10):2159-2167
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Sleeve gastrectomy(SG)has become the most widely performed bariatric procedure worldwide,but postoperative gastroesophageal reflux disease(GERD)remains a major concern.This multicenter study aimed to identify independent risk factors associated with GERD after SG to guide preoperative assessment and intraoperative management.Methods:Clinical data of 672 patients who underwent SG between January 2020 and December 2022 in six bariatric centers and completed a 12-month follow-up were retrospectively analyzed.Demographic characteristics,esophagogastric junction(EGJ)integrity graded by the AFS system,operative parameters,and postoperative outcomes were compared between patients with and without GERD.Multivariate logistic regression was used to identify predictors of postoperative GERD.Results:The overall incidence of GERD after SG was 24.7%(166/672).Multivariate analysis revealed that a preoperative BMI>35 kg/m2(OR=1.68,P=0.033),EGJ integrity AFS grade>2(OR=2.90,P=0.006),and preoperative reflux symptoms(OR=2.44,P=0.030)were independent risk factors for GERD.A staple line more than 1 cm from the angle of His(OR=0.45,P<0.001)and a bougie size>36 Fr(OR=0.08,P=0.001)were protective factors.Conclusion:High BMI,impaired EGJ integrity,and preoperative reflux symptoms significantly increase the risk of GERD after SG,whereas adequate preservation of the His angle and appropriate bougie calibration may reduce it.Comprehensive preoperative EGJ assessment and standardized surgical techniques are essential for minimizing postoperative reflux.
