Removed Stomach After Sleeve Gastrectomy: Is Routine Pathological Examination Necessary?

Year 2022, Volume: 9 Issue: 2, 169 - 173, 24.08.2022

Emin Lapsekili Ümit Alakuş

https://doi.org/10.47572/muskutd.949327

Abstract

Laparoscopic sleeve gastrectomy is the most commonly used method in bariatric surgery. The aim of this study is to examine the histopathological findings frequently encountered in the pathological examination of the stomach removed after the sleeve gastrectomy procedure, which is preferred in the surgical treatment of obesity, and to discuss the necessity of routine pathological evaluation of removed stomach. The files of 102 consecutive patients who underwent sleeve gastrectomy between January 2017 and December 2020 were analyzed retrospectively. In the pathological examination, pathologies other than the normal gastric mucosa were evaluated in terms of the severity of inflammation, activity, presence of atrophy, intestinal metaplasia, helicobacter pylori (HP) positivity, and abnormal histopathological findings. The mean age of the patients, the majority of whom were women (n=79, 77.5%), was 43.2±12.0 (16-69). Mean preoperative body weight was 128.0±16.8 kg; mean body mass index was determined as 46.7±8.4. There was no malignant or premalignant lesion that would change the treatment modality, such as dysplasia or metaplasia, in any of the patients. Preoperative endoscopy is important both to find a pathological diagnosis and to determine reflux. We support the opinion that if a pathology is observed in the intraoperative macroscopic examination, the specimen should be submitted for histopathological examination.

Keywords

Gastric Specimen, Pathology, Sleeve Gastrectomy

Sleeve Gastrektomi Sonrası Çıkarılan Gastrektomi Materyali: Patolojik İnceleme Gerekli mi?

Abstract

Laparoskopik sleeve gastrektomi, obezite cerrahisinde en sık kullanılan yöntemdir. Bu çalışmanın amacı obezitenin cerrahi tedavisinde tercih edilen sleeve gastrektomi prosedürü sonrasında çıkarılan midenin patolojik incelemesinde sıklıkla karşılaşılan histopatolojik bulguları incelemek ve çıkarılan bu parçaların rutin patolojik değerlendirme gerekliliğini tartışmaktır. Ocak 2017 ile Aralık 2020 tarihleri arasında sleeve gastrektomi uygulanan ardışık 102 hastanın dosyası retrospektif olarak analiz edildi. Patolojik incelemede normal gastrik mukoza dışındaki patolojiler inflamasyonun şiddeti, aktivitesi, atrofi varlığı, intestinal metaplazi, helikobakter pilori (HP) pozitifliği ve anormal histopatolojik bulgular yönünden değerlendirildi. Büyük çoğunluğu kadın olan (n=79, %77.5) hastaların yaş ortalaması 43.2±12.0 (16-69) idi. Ortalama preoperatif vücut ağırlıkları 128.0±16.8 kg; vücut kitle indeksleri ise 46.7±8.4 olarak belirlendi. Hiçbir hastada displazi veya metaplazi gibi tedavi modalitesini değiştirecek malign ya da premalign lezyona rastlanmadı. Preoperatif endoskopi hem patolojik bir tanının bulunabilmesi hem de reflünün belirlenmesi için önemlidir. İntraoperatif yapılacak olan makroskopik incelemede bir patoloji görülmesi halinde, piyesin histopatolojik incelemeye iletilmesi gerektiği kanaatini destekliyoruz. 

Keywords

Gastrik Spesmen, Patoloji, Sleeve Gastrektomi

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