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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Unexpected histopathological findings after sleeve gastrectomy
Surgical Endoscopy, Volume 34, No. 5, Year 2020
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Description
Background: Laparoscopic sleeve gastrectomy (LSG) represents one of the most commonly performed bariatric procedures and, in contrast to the Roux-en-Y gastric bypass, produces a specimen for pathologic examination. This study aims to describe unexpected histopathological findings in order to better define preoperative management of patients undergoing LSG. Methods: All LSG cases performed at an academic center in Toronto, Ontario between 2010 and 2017 were reviewed. All specimens underwent histopathological assessment, while those with findings suspicious for neoplasia or the presence of Helicobacter pylori underwent additional immunohistochemical stainings. Baseline patient characteristics and surgical outcomes were obtained from our internal database. Results: A total of 222 patients underwent LSG during the study period and had their specimens examined histologically. Among them, 22.5% underwent preoperative endoscopy. The most common histopathological diagnosis was no abnormal findings (50.9%) followed by gastritis (25.7%). Abnormal findings warranting a change in postoperative management or follow-up were discovered in 8.6% of specimens and included H. pylori infection, intestinal metaplasia, malignancy, and atrophic gastritis. Only 4.7% of all patients had not undergone preoperative endoscopy and had truly unexpected findings. No significant association was found between abnormal findings and age, sex, or baseline body mass index (BMI). Conclusions: Although a majority of patients had a gastric specimen within normal limits, 8.6% had findings requiring a change in postoperative management. This rate dropped to 4.7% when patients whose diagnoses were known preoperatively were excluded. Our findings suggest that further research is needed to better define the role of preoperative endoscopy to potentially reduce the number of unexpected findings following LSG. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Authors & Co-Authors
Alhabdan, Sultan
Unknown Affiliation
Chetty, Runjan M.
Canada, Toronto
University of Toronto
Serra, Stefano
Canada, Toronto
University of Toronto
Okrainec, Allan
Canada, Toronto
University of Toronto
Canada, Toronto
University Health Network University of Toronto
Statistics
Citations: 7
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.1007/s00464-019-07002-7
ISSN:
09302794
Research Areas
Health System And Policy
Study Design
Cohort Study