减重代谢手术后胃胸腔内移位处理中国专家共识(2026年版)OA
Chinese expert consensus on the management of intrathoracic gastric migration after metabolic bariatric surgery(2026 edition)
胃胸腔内移位(ITGM)是减重代谢手术后常见的一种并发症,可发生于多种术式后,在胃袖状切除术后报道最多.ITGM的发生与术中解剖结构破坏、术后固定组织薄弱、胸腹腔压力梯度等多种因素有关,可无症状或表现为胃食管反流病相关症状,目前尚无统一的诊断标准和规范化处理策略.为提高我国减重代谢手术后ITGM的诊疗水平,中国医师协会外科医师分会肥胖和代谢病外科专家工作组、北京医师协会减重与代谢专科医师分会组织国内117位相关领域专家,基于最新文献和临床经验,就ITGM的诊断方法、监测策略、手术干预指征,以及不同减重术式术后ITGM的具体处理方案等16个核心问题达成专家共识.本共识旨在为我国减重代谢手术后ITGM的诊断、处理及手术策略选择提供循证依据,并为临床规范化诊疗提供参考,未来仍需更多高质量研究进一步完善相关证据.
Intrathoracic gastric migration(ITGM)is a common complication following metabolic bariatric surgery,occurring after various procedures,with the highest reported incidence after sleeve gastrectomy.The pathogenesis of ITGM is multifactorial,including intraoperative anatomical disruption,postoperative weakening of gastric fixation structures,and thoracoabdominal pressure gradients.Patients may be asymptomatic or present with symptoms related to gastroesophageal reflux disease.Currently,there is no unified diagnostic criteria or standardized management strategy for ITGM.To improve the diagnosis and treatment of ITGM after metabolic bariatric surgery in China,the Chinese Society for Metabolic and Bariatric Surgery and Beijing Metabolic&Bariatric Doctor Association convened a panel of 117 experts nationwide to develop a consensus based on the latest evidence and clinical experience.The consensus addresses 16 key issues,including diagnostic methods,monitoring strategies,indications for surgical intervention,and specific management protocols for ITGM following different metabolic bariatric procedures.This consensus provides evidence-informed recommendations for the diagnosis and management of ITGM after metabolic bariatric surgery in China.Further high-quality prospective studies are needed to strengthen the evidence base and optimize future recommendations.
中国医师协会外科医师分会肥胖和代谢病外科专家工作组;北京医师协会减重与代谢专科医师分会;朱晒红;张鹏;白日星;梁辉;朱孝成;朱利勇
医药卫生
减肥手术胃切除术胃食管反流疝,食管裂孔多数赞同
Bariatric SurgeryGastrectomyGastroesophageal RefluxHernia,HiatalConsensus
《中国普通外科杂志》 2026 (8)
1508-1519,12
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