Can histopathology of gastric tissue resected in sleeve gastrectomy be informative about serum iron levels?

Abstract

One of the most common post-operative deficiencies after bariatric surgery is iron deficiency and one of the important determinants of post-operative iron deficiency is the preoperative condition. In this study, it was aimed to investigate the relationship between iron levels and histopathological findings observed in gastric tissue resected in sleeve gastrectomy. Preoperative and postoperative iron levels were compared with the presence of inflammation, atrophy, Helicobacter pylori, intestinal metaplasia, lymphoid follicles, and lymphoid aggregates observed in patients operated due to morbid obesity. The postoperative serum iron levels and preoperative values were compared and a statistically significant increase was found due to the use of iron-containing preparations after the operation. Among the parameters evaluated, inflammation, atrophy, Helicobacter pylori, intestinal metaplasia, and the presence of lymphoid follicles were not found to be associated with iron levels, but it was noted that the presence of lymphoid aggregate in all cases and male cases was correlated with preoperative low iron levels (p values 0.047 and 0.015 respectively). In this study, which investigated the role of histopathological findings in the prediction of iron deficiency in sleeve gastrectomies, the relationship between preoperative iron levels, which was reported to be predictive for post-operative iron deficiency, and the presence of lymphoid aggregates was revealed. It is thought that other histopathological findings such as the presence of lymphoid follicle and Helicobacter pylori are also important in terms of iron levels but could not be revealed due to the limitations of the study.