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Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens: Prevalence, Risk Factors, and Value of Routine Histopathologic Examination
Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Doha, Qatar. (Individ och samhälle (VIDSOC), Individual and Society)
Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
2017 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 27, no 7, p. 1741-1749Article in journal (Refereed) Published
Abstract [en]

Laparoscopic sleeve gastrectomy (LSG) is a common surgical therapeutic option for obese patients, with debate about the value of routine histopathologic examination of LSG specimens. We assessed the following: prevalence of different histopathologic changes in LSG specimens, risk factors associated with premalignant and with frequent histopathologic changes, and whether routine histopathologic examination is warranted for LSG patients with nonsignificant clinical history. Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (February 2011-July 2014, n = 1555), was conducted. Risk factors (age, BMI, gender, and Helicobacter pylori) were assessed in relation to specific abnormal histopathologic changes. Mean age and BMI of our sample were 35.5 years and 46.8, respectively. Females comprised 69.7% of the sample. Normal histopathologic specimens comprised 52% of the sample. The most common histopathologic changes were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), and lymphoid aggregates (2.2%). We observed rare histopathology in 3.3% of the sample [e.g., intestinal metaplasia and gastrointestinal stromal tumor (GIST)]. Older age was associated with GIST and intestinal metaplasia (P = 0.001 for both). Females were associated with chronic active gastritis (P = 0.003). H. pylori infection was associated with follicular gastritis, lymphoid aggregates, GIST, intestinal metaplasia, and chronic active gastritis (P < 0.001 for each). Older age, H. pylori, and female gender are risk factors for several abnormal histopathologic changes. Histopathologic examination of LSG specimens might harbor significant findings; however, routine histopathologic examination of all LSG specimens, particularly in the absence of suggestive clinical symptoms, is questionable. The association between female gender and chronic active gastritis; and the association between H. pylori infection and GIST are both novel findings that have not been previously reported in the published literature.

Place, publisher, year, edition, pages
Springer, 2017. Vol. 27, no 7, p. 1741-1749
Keywords [en]
Morbid obesity, Sleeve gastrectomy, Stomach, Histopathologic examination, H. pylori, GIST, Intestinal metaplasia
National Category
Clinical Medicine Health Sciences
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-14262DOI: 10.1007/s11695-016-2525-1ISI: 000404529600017PubMedID: 28063114Scopus ID: 2-s2.0-85008440576OAI: oai:DiVA.org:his-14262DiVA, id: diva2:1152812
Note

Affiliations according to the erratum of the article. The erratum can be found at https://10.1007/s11695-017-2819-y. Some author affiliations were omitted in the original article and the name of author Tamer Saafan was misspelled.

Available from: 2017-10-26 Created: 2017-10-26 Last updated: 2018-02-16Bibliographically approved

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El Ansari, Walid

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