Histopathological Findings in Morbid Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: Does H. pylori Infection Effective on Pathological Changes?

Öner, Ramazan İlyas; Özdaş, Sabri

doi:10.1007/s11695-018-3250-8

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…In the light of, the higher percentage of a large range of upper GI tract disorders in obese patients in our study that were confirmed with similar studies done on histopathological specimens of LSG [30][31][32]. We recommend performing a routine preoperative endoscopic evaluation for patients before bariatric surgery even if they are asymptomatic, which may help in the diagnosis of GI pathologies affecting both the surgery and the bariatric follow-up.…”

Section: Discussionsupporting

confidence: 89%

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

Tawfik

Aldawas

Almegbil

et al. 2022

Gastroenterology Research and Practice

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Introduction. Saudi Arabia (SA) is one of the top countries in the world when it comes to the number of bariatric procedures performed each year. There is still some debate on whether to do regular or selective upper endoscopy during the preoperative examination. The purpose of this study was to explore various endoscopic findings and Helicobacter pylori (HP) infection in symptomatic and asymptomatic patients having laparoscopic sleeve gastrectomy (LSG) prior to surgery. Methods. We investigated a cohort of 132 patients referred to the endoscopy unit from the bariatric surgery outpatient clinic for prebariatric esophagogastroduodenoscopy (EGD) as a part of preoperative LSG. Data extraction from medical records included clinical data such as body mass index (BMI), gastrointestinal symptoms (that include heartburn, regurgitation, epigastric pain, and nausea), medical comorbidities, and laboratory investigations. It included data about the endoscopic findings of EGD procedure as esophageal, gastric, and duodenal findings results as well as the results of biopsy specimens that were taken. Results. Out of 132 patients, 29 (22%) had a BMI of less than 40 kg/m2 whereas 103 (78%) had a BMI of 40 kg/m2 or above, with an average of 44.4 ± 6.4 kg/m2. The average age of participants was 33.6 ± 10.4 years. HP was detected in 36 patients (35.0%) with a slightly greater prevalence in patients with a higher BMI (33.7%) than in patients with lower BMI (35.0%). Collectively, 73 patients (55.7%) had positive endoscopic findings of various grades, sites, and combinations. Incompetent cardia (35.6%) was the most often seen esophageal finding, antral gastritis (34.1%) was the most frequently encountered gastric finding, and duodenitis 1st part was the commonest duodenal endoscopic finding (7.8%). Among asymptomatic patients, incompetent cardia was detected in 33.3%, antral gastritis was found in 30.1%, and around one-quarter of them were positive on HP testing (26.6%). Additionally, 16.1% of them had signs of reflux esophagitis, 17.2% had hiatal hernia, and 14.0% had nodular gastritis. Conclusion. The current study revealed a high prevalence of positive endoscopic findings as well as HP infection upon routine endoscopic examination among patients undergoing bariatric surgery even those who were asymptomatic from any gastrointestinal symptoms.

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Section: Discussionsupporting

confidence: 89%

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

Tawfik

Aldawas

Almegbil

et al. 2022

Gastroenterology Research and Practice

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“…Although these findings may cause the surgeon to change the way of treatment in the postoperative period, most of the reported diagnoses do not require further clinical follow-up (14). In our series, there was no patient requiring treatment change in the postoperative period.…”

Section: Discussionmentioning

confidence: 56%

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

Batman¹,

Altun²

2020

Istanbul Med J

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Amaç: Obezite sıklığı tüm dünyada artmaktadır. Laparoskopik sleeve gastrektomi (LSG) günümüzde dünya genelinde en sık uygulanan bariatrik cerrahi olarak yerini almıştır. Diğer bariatrik cerrahilerin aksine LSG'de patolojik inceleme yapılabilecek bir piyes çıkmaktadır. Bu çalışmanın amacı LSG'yi takiben beklenmeyen histopatolojik bulguları tanımlamaktır. Results: One thousand three hundred sixty four patients underwent LSG. The mean age was 40.93±10.86 years; 974 patients (71.48%) were female. The mean BMI was 42.23±7.28. The most common findings in the pathologies were normal gastric specimen (50%), gastritis (30%) and changes due to proton pump inhibitor use (23%) respectively. Conclusion: Gastroscopy should be added to the preoperative preparation process in cases where there is no gastric specimen after the operation. Preoperative gastroscopy is not a necessity for laparoscopic sleeve gastrectomy. It can be performed in selected cases.

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“…An explanation for these discrepancies in pathological results found across the published studies may be represented by the different classifications of abnormal histopathological findings that were used in different countries. For instance, Oner et al [20] used the same classification as ours, but they found chronic gastritis in 96.9% of the cases, as the most common abnormal finding, followed by lymphoid aggregates and active chronic gastritis in 87.2% and 29.2%, respectively. In another study by Adalı et al [21], they also used the same classification as ours, but besides that, they had one more item, namely "lymphoid follicles", which was encountered in 59.5% of the cases.…”

Section: Discussionmentioning

confidence: 62%

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

Mocian

Sorlea

Coroș

2023

Medicine and Pharmacy Reports

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Background and aims. This study aimed to investigate the relationship between baseline characteristics of obese patients and histopathological findings on resected gastric specimens resulted after laparoscopic sleeve gastrectomy. Methods. Seventy-seven patients undergoing laparoscopic sleeve gastrectomy in a university surgical department from Romania were included in the present study. Demographic data, preoperative Body Mass Index values, and their relationship with the histopathological findings of resected gastric specimens were statistically analyzed. Results. The mean age of patients included was 40.2 ± 11.05 years and the mean Body Mass Index was 43.5 ± 7.8 kg/m2; 71.4% of the patients were female. Active chronic gastritis was the most common gastric pathology (39%) encountered. Helicobacter pylori infection was present in 27.2% of the cases. Normal gastric histology was found in 33.7% of the specimens. A strong statistically significant association was noted between Helicobacter pylori infection and active chronic gastritis (p<0.0001). Similarly, a statistically significant association was observed between age, Body Mass Index, and intestinal metaplasia (p=0.005 and p=0.009 respectively). No malignancies were found. Conclusions. Our study results show that the incidence of active chronic gastritis and Helicobacter pylori infection is relatively high in obese patients. Considering this, we conclude that it is important to send the resected gastric specimens for histopathological analysis after laparoscopic sleeve gastrectomy.

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Histopathological Findings in Morbid Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: Does H. pylori Infection Effective on Pathological Changes?

Cited by 13 publications

References 28 publications

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

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

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