Iranian Journal of Colorectal Research

Iranian Journal of Colorectal Research

Pathological Review of Resected Gastric Specimens Following Laparoscopic Sleeve Gastrectomy Over Four Years at Two Major Referral Hospitals in Shiraz, Iran

Document Type : Research/Original Article

Authors
Faranak Bahrami 1
Arian Najdi 1
Khadijeh Gorgi 1
Mohammed Abd-zaid Akool 2
Hajar Khazraei 1
1 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Surgery, Faculty of Medicine, Jabir Ibn Hayyan Medical University, Najaf, Iraq
10.30476/acrr.2023.99280.1180
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 conducted a histopathologic evaluation of resected stomach specimens after laparoscopic sleeve gastrectomy.
Methods: We evaluated the medical records of 827 patients who underwent laparoscopic sleeve gastrectomy between 2015 and 2018 at two major referral hospitals in Shiraz, Iran. In this retrospective study, the pathological findings of resected stomach specimens and other variables such as age, sex, preoperative body mass index (BMI), and comorbid illnesses were evaluated. 
Results: 653 cases (78.9%) had chronic gastritis in some form; lymphoid follicle formation (in 197 cases), acute on chronic gastritis (in 67 cases), complete intestinal metaplasia (in 5 cases), hyperplastic polyps (in 5 cases), and gastrointestinal stromal tumors (GISTs) (2 cases) were the next most common findings. Most lymphoid follicle formation was reported in the context of gastritis. Two patients with GIST and one with submucosal lymphoma received further treatment.
Conclusion: Abnormal histopathologic findings were found in 88% of sleeve gastrectomy specimens. only one case of malignancy was found, less than 15% of samples were completely normal. Results of our study indicate high rate of abnormal pathologies in reseted gastric specimens.
Keywords
Obesity
morbid
Bariatric surgery
Laparoscopy
Gastrectomy
Gastritis
  1. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA surgery. 2014;149(3):275-87.
  2. Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric surgery and long-term cardiovascular events. Jama. 2012;307(1):56-65.
  3. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obesity surgery. 2013;23(4):427-36.
  4. Hansen SK, Pottorf BJ, Hollis HW, Jr., Rogers JL, Husain FA. Is it necessary to perform full pathologic review of all gastric remnants following sleeve gastrectomy? American journal of surgery. 2017;214(6):1151-5.
  5. Clapp B. Histopathologic findings in the resected specimen of a sleeve gastrectomy. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2015;19(1):e2013.00259.
  6. Almazeedi S, Al-Sabah S, Al-Mulla A, Al-Murad A, Al-Mossawi A, Al-Enezi K, et al. Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies. Obesity surgery. 2013;23(3):314-9.
  7. Dehdari T, Dehdari L, Jazayeri S. Diet-Related Stomach Cancer Behavior Among Iranian College Students: A Text Messaging Intervention. Asian Pacific journal of cancer prevention : APJCP. 2016;17(12):5165-72.
  8. Akhavan A, Binesh F, Seifaddiny A. Results of combination chemotherapy and radiation therapy in non-metastatic gastric cancer in Yazd--Iran. Indian journal of cancer. 2015;52(1):40-3.
  9. Movahedi M, Afsharfard A, Moradi A, Nasermoaddeli A, Khoshnevis J, Fattahi F, et al. Survival rate of gastric cancer in Iran. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2009;14(6):367-73.
  10. Zendehdel N, Nasseri-Moghaddam S, Malekzadeh R, Massarrat S, Sotoudeh M, Siavoshi F. Helicobacter pylori reinfection rate 3 years after successful eradication. Journal of gastroenterology and hepatology. 2005;20(3):401-4.
  11. Keramati MR, Sadeghian MH, Ayatollahi H, Badiee Z, Shakibayi H, Moghimi-Roudi A. Role of the Lewis and ABO Blood Group Antigens in Helicobacter pylori Infection. The Malaysian journal of medical sciences : MJMS. 2012;19(3):17-21.
  12. Compare D, Rocco A, Nardone G. Risk factors in gastric cancer. European review for medical and pharmacological sciences. 2010;14(4):302-8.
  13. Kalan Farmanfarma K, Mahdavifar N, Hassanipour S, Salehiniya H. Epidemiologic Study of Gastric Cancer in Iran: A Systematic Review. Clinical and experimental gastroenterology. 2020;13:511-42.
Iranian Journal of Colorectal Research
Volume 11, Issue 2
Spring 2023
Pages 68-72