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Surgical Endoscopy

, Volume 33, Issue 12, pp 4003–4007 | Cite as

Pathologic findings of the removed stomach during sleeve gastrectomy

  • Li Ge
  • Rena C. Moon
  • Ha Nguyen
  • Luiz Gustavo de Quadros
  • Andre F. Teixeira
  • Muhammad A. JawadEmail author
Article

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is the preferred surgical intervention to treat morbid obesity. Despite the rising popularity of LSG, little is known on the histopathologic findings of the resected partial stomach specimens. Our study aims to identify prevalent pathologic findings of the removed stomach and explore the association between patient characteristics and abnormal findings.

Methods

A retrospective analysis was conducted using a prospectively maintained database of 649 patients who underwent LSG between November 1, 2013 and December 31, 2015 at our institution. Patient characteristics included age, body mass index, gender, and preoperative comorbidities (diabetes, hyperlipidemia, depression, gastroesophageal reflux, hypertension, and sleep apnea). Statistical analysis was performed using descriptive analysis and logistic regression models.

Results

Abnormal pathologic findings were identified in approximately one-fifth (n = 142, 21.9%) of the patients. The most common find is non-specific chronic gastritis (9.7%), followed by Helicobacter pylori gastritis (4.9%). Approximately 15% of patients had significant histopathological alterations that might require further investigation, treatment, or follow-up, including non-specific chronic gastritis, H. pylori gastritis, autoimmune atrophic gastritis, and gastrointestinal stromal tumor. The odds of abnormal findings in patients without hyperlipidemia was 0.09 times the corresponding odds in those with hyperlipidemia (95% CI 0.03–0.29), controlling for factors including age, body mass index, gender, and other preoperative comorbidities.

Conclusion

Patients with gastroesophageal reflux and hyperlipidemia might suggest higher incidence rate of gastric histopathologic abnormalities. Routine preoperative screening may not be beneficial for patients undergoing sleeve gastrectomy.

Keywords

Sleeve gastrectomy Pathology Stomach 

Notes

Compliance with ethical standards

Disclosures

Dr. Andre Teixeira is a consultant for Intuitive Surgical and Ethicon Endo-Surgery. Dr. Muhammad Jawad is a consultant for Ethicon Endo-Surgery. Dr. Li Ge, Dr. Rena Moon, Dr. Ha Nguyen, and Dr. Gustavo Quadros have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PathologyOrlando Regional Medical Center, Orlando HealthOrlandoUSA
  2. 2.Department of Bariatric SurgeryOrlando Regional Medical Center, Orlando HealthOrlandoUSA
  3. 3.Department of Bariatric EndoscopyKaiser Day HospitalSão José do Rio PretoBrazil

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