Objective:To explore the therapeutic efficacy of laparoscopic Roux-en-Y gastric bypass on patients with overweight or obesity who combined with hiatal hernia.Methods:This retrospective study analyzed the clinical and follow-up data of 4 patients with obesity or overweight combined with hiatal hernia who underwent bariatric surgery from Nov.2012 to Dec.2019.Results:A total of four patients were included:two overweight with type 2 diabetes and two obesity with diabetes or glucose intolerance.All four patients presen-ted with hypertension and dyslipidemia.Preoperative gastroscopy suggested hiatal hernia in three cases,two of which exhibited a combi-nation of reflux esophagitis(grade La-B)and a diagnosis of gastroesophageal reflux disease.Intraoperative exploration confirmed a hiatal hernia in all the patients.Roux-en-Y gastric bypass was performed in four patients.The hiatal hernia were not repaired.The post-operative follow-up period ranged from 2 to 11.5 years.Obese patients experienced significant weight loss within 1 year after surgery,withpercentage of excess weight loss of 63.64%and70.59%,respectively.Two overweight patients with diabetes exhibited elevated blood glucose levels at 6 months and 5 years after surgery,whereas the other patient with obesity and diabetes had complete remission.Four patients did not experience gastroesophageal reflux symptoms postoperatively.One patient developed mild anemia postoperatively,and hypertension was alleviated in all patients,with no abnormalities in liver function and blood lipids.Conclusions:Roux-en-Y gastric bypass demonstrates efficacy in reducing weight among patients with obesity concomitant with hiatal hernia,and exhibits significant improvement in comorbidities associated with overweight or obesity.The absence of gastroesophageal reflux symptoms during the post-operative follow-up period preliminarily indicates the safety and effectiveness of this procedure in overweight or obese patients with hiatal hernia.
维普
万方数据