Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens?

Abstract

Background Obesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or premalignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes. Method Retrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens.Results Females comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies. Conclusion When confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates.

Histopathological findings on resected gastric specimens from obese patients undergoing laparoscopic sleeve gastrectomy

“…Histopathological examination of the resected gastric specimens revealed normal histology in 33.7% of the cases, almost equal to those published by Raess et al (35.2%) [12], but slightly higher than those published by Komaei et al [14] and Demirbas et al [15] where they found normal histology in 25.5% and 25.7% of the specimens, respectively. On the other hand, some published studies reported a higher rate of normal histology compared to our results (50.9% and 52%, respectively) [16,17].…”

Association of Hypercholesterolemia With Gastric Intestinal Metaplasia, Findings After Sleeve Gastrectomy Pathology Review

“…Previous serious review of histopathologic findings after VSG revealed the prevalence of IM to be between 0.3% and 9.9% of cases. [8][9][10]18,[23][24][25][26][27][28] In our study, IM was detected in 5.3% of all specimens after VSG.…”

“…12 In one cohort study, higher BMI revealed an independent correlation factor with the presence of IM, 34 although there are some other studies that did not confirm any relationship between IM and patient's BMI. 26,35 Another study found that age older than 60 years related to an increased the risk of IM in a Japanese population. 31 It seems that older age, H. pylori infection and a higher BMI may play important roles as etiologies of IM.…”

“…In addition, smoking and alcohol consumption are 2 risk factors associated with IM 12. In one cohort study, higher BMI revealed an independent correlation factor with the presence of IM,34 although there are some other studies that did not confirm any relationship between IM and patient’s BMI 26,35. Another study found that age older than 60 years related to an increased the risk of IM in a Japanese population 31.…”

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

“…Moreover, Hp -I has been repeatedly associated with MetS and IR, as well as its hepatic component nonalcoholic fatty liver disease, recently renamed as the metabolic dysfunction-associated fatty liver disease [ 14 , 15 , 16 ]. In this regard, the incidence of Hp -I in bariatric patients and characterization of the mentioned main histopathologic precancerous lesions being found incidentally in the gastric biopsies is an attractive correlation, which has been performed only in few studies [ 4 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. In this retrospective study, we aimed to investigate, for the first time in Switzerland, the presence of the mentioned main histological precancerous lesions in gastric mucosa biopsies obtained in terms of a planned bariatric surgery and correlate them with a variety of metabolic parameters through the prism of Hp -I.…”