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Clinical significance of colonoscopy before laparoscopic bariatric/metabolic surgery in Japanese patients

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Abstract

Purpose

Obesity is known to be associated with colorectal adenoma (CRA) and colorectal cancer (CRC); yet colonoscopy is not considered an essential preoperative evaluation before bariatric/metabolic surgery. The aim of this study was to clarify the clinical significance of preoperative colonoscopy for obese Japanese patients.

Methods

The subjects of this retrospective study were 114 patients who underwent screening colonoscopy before bariatric/metabolic surgery. Multivariate analyses were performed to evaluate the independent predictors of CRA/CRC among the characteristics identified as significant or nearly significant by univariate analyses.

Results

Colonoscopy revealed abnormal findings indicating the need for biopsy or polypectomy in 20 of the 114 patients (17.5%), and CRA was diagnosed in 13 patients (11.4%). Three patients (2.6%), who were all ≥ 56 years old, had a CRA ≥ 10 mm in diameter. The multivariate analysis showed that older age and male sex were significant predictors of CRA/CRC, which was identified in 46.2% of the male patients aged ≥ 46 years.

Conclusion

Our findings suggest that older age and male sex may be risk factors for CRA/CRC in obese Japanese candidates for bariatric/metabolic surgery; thus, preoperative colonoscopy should be considered for these high-risk patients.

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Acknowledgements

We thank Ms. Kazuyo Adachi, Ms. Satoko Tone, Ms. Yuko Hirota, and Ms. Kaoru Hirano for their nutritional evaluation and education.

Funding

This study received no financial support and the authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan

    Masayuki Ohta

  2. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan

    Masayuki Ohta, Yuichi Endo, Hidefumi Shiroshita, Takahide Kawasaki, Takashi Masuda, Teijiro Hirashita & Masafumi Inomata

  3. Department of Gastroenterology, Oita University Faculty of Medicine, Oita, Japan

    Kensuke Fukuda, Ryo Ogawa, Kazuhiro Mizukami & Kazunari Murakami

  4. Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Oita University Faculty of Medicine, Oita, Japan

    Takayuki Masaki

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  1. Masayuki Ohta
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  2. Yuichi Endo
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Correspondence to Masayuki Ohta.

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Ethical approval

All data collection and analyses were performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. The study was approved by the Ethics Committee of Oita University Faculty of Medicine (#1962).

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Ohta, M., Endo, Y., Shiroshita, H. et al. Clinical significance of colonoscopy before laparoscopic bariatric/metabolic surgery in Japanese patients. Surg Today 54, 80–85 (2024). https://doi.org/10.1007/s00595-023-02706-9

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  • DOI: https://doi.org/10.1007/s00595-023-02706-9

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