减重代谢手术前后规范化胃镜检查的分析研究

目的从消化内镜医生角度来分析减重手术前后消化道腔内的特征及远期随诊。 方法回顾性分析2020年6月1日至2021年11月30日经首都医科大学附属复兴医院减重患者132例，对比手术前后7 620张胃镜图片。 结果减重手术前的胃镜检查显示，52例(39.4%)发现存在滑动型食管裂孔疝、27例(20.4%)存在反流性食管炎、19例(14.4%)存在胃体黏膜网格样充血水肿、胃窦黏膜颗粒样改变、十二指肠肠绒毛短缩。减重手术后胃镜检查显示，溃疡病腹腔镜袖状胃切除术(LSG)后发生率约2.9%(1例)、腹腔镜Roux-en-Y胃旁路术(LRGB)后发生率约5.3%(1例)；均未发生吻合口炎。 结论对减重手术1年后的胃镜检查随访未发现消化道息肉及肿瘤倾向，针对肥胖症的治疗及防控多学科协作任重道远。

Analysis of standardized gastroscopy before and after bariatric surgery

ObjectiveTo analyze the characteristics and long-term follow-up of gastrointestinal tract before and after bariatric surgery from the perspective of digestive endoscopy. MethodsA total of 132 patients with weight loss in Fuxing Hospital affiliated to Capital Medical University was selected from June 1st 2020 to November 30th 2021.7 620 gastroscopic images before and after surgery were compared. ResultsGastroscopic examination before weight reduction revealed that sliding hiatal hernia was found in 39.4% of patients.20.4% of patients had reflux esophagitis. About14.4% patients had hyperemia and edema of gastric mucosa, granuloid changes of gastric antrum mucosa and shortening of duodenal and intestinal villi before weight loss.The incidence of ulcer disease after weight reduction surgery was about 1.9%.No stomatitis was found. ConclusionThere was no polyp or tumor tendency in endoscopic follow-up one year after weight loss surgery.Multidisciplinary collaboration in the treatment and prevention and control of obesity remains a long way to go.