Pathology review of the resected gastric specimens following laparoscopic sleeve gastrectomy in two major referral centers in Shiraz Hospitals in four years periods of time

Document Type : Research/Original Article

Authors

1 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran

2 Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Department of Surgery, Faculty of Medicine, Jabir Ibn Hayyan Medical University, Najaf, Iraq.

Abstract

Background: Bariatric surgery is the most effective treatment for morbid obesity, resulting in long-term weight loss and considerable improvements in coexisting conditions. We designed this study to histopathologic evaluation of resected stomachs after sleeve gastrectomy.
Methods: In this study, files of 827 patients who underwent sleeve gastrectomy between 2015 and 2018 in Shiraz were evaluated. In this retrospective cross-sectional study, the pathology findings of resected stomachs and other variables such as age, sex, preoperative BMI, and comorbid illnesses were evaluated.
Results: Six hundred and fifty-three cases (78.9%) had chronic gastritis in some forms. Lymphoid follicle formation (in 197 cases), acute chronic gastritis (in 67cases), complete intestinal metaplasia (in 5 cases), hyperplastic polyp (in 5 cases), and gastrointestinal stromal tumor (GIST) (2 cases) were in the next positions respectively. Most the lymphoid follicle formation was reported in the context of gastritis. Two patients with GIST and one with submucosal lymphoma underwent more evaluation and proper treatment at that time.
Conclusion: The rate of other abnormal histopathologic findings of resected stomachs was about 88 % in our study. No malignancy was found in the current study but less than 15% of samples were totally normal. Because of the high rate of abnormal pathology in resected gastric specimens in this trial and the fact that gastric cancer is the most common gastrointestinal malignancy in Iran, it is recommended that all patients in our region who are candidates for sleeve gastrectomy should have an upper gastrointestinal endoscopy prior to surgery.

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