摘要胃袖状切除术是目前最常见的减重手术方式，对肥胖合并食管裂孔疝患者，其胃袖状切除术中的处理策略尚存在争议。目前国内主流策略是术中积极探查并修补食管裂孔疝，但已有部分研究报道其效果并不明确，甚至可能诱发胃食管反流症状。笔者详细阐述胃袖状切除术中食管裂孔疝治疗方式的现状，并结合既往经验，探讨肥胖合并食管裂孔疝患者在施行胃袖状切除术中的临床处理策略。

abstractsSleeve gastrectomy is currently the most commonly performed bariatric surgery procedure. There remains controversy regarding the intraoperative management of hiatal hernia during sleeve gastrectomy for obesity patients. In China, the mainstream approach is active explora-tion and repair of the hiatal hernia during surgery. Nevertheless, some reports suggest that this may not lead to definitive outcomes and might even exacerbate gastroesophageal reflux symptoms. Based on clinical experience, the authors discuss the current strategies of intraoperative management of hiatal hernia during sleeve gastrectomy, and explore the clinical management strategies for obesity patients with esophageal hiatal hernia undergoing sleeve gastrectomy.