Raess PW, Baird-Howell M, Aggarwal R, Williams NN, Furth EE. Vertical sleeve gastrectomy specimens have a high prevalence of unexpected histopathologic findings requiring additional clinical management.
Surg Obes Relat Dis 2015;
11:1020-3. [PMID:
25868840 DOI:
10.1016/j.soard.2015.01.002]
[Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 12/23/2014] [Accepted: 01/05/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND
Laparoscopic vertical sleeve gastrectomy is used with increasing frequency as a therapeutic option for morbid obesity. Before the procedure, patients undergo a rigorous preoperative evaluation including double contrast upper gastrointestinal radiographic series at our institution. Patients undergoing sleeve gastrectomy are presumed to have no significant gastric pathology.
OBJECTIVES
To investigate the prevalence of histopathologic findings requiring clinical follow-up in sleeve gastrectomy specimens.
SETTING
University Hospital, United States.
METHODS
Retrospective review was conducted of all primary vertical sleeve gastrectomy specimens performed for morbid obesity at our institution from July 2008 until August 2012 (N = 248).
RESULTS
Unanticipated findings warranting clinical follow-up were identified in 8.4% of cases and included cases of H. pylori gastritis, autoimmune gastritis with microcarcinoid formation, necrotizing vasculitis, and intestinal metaplasia. H. pylori was identified in 5.2% of all cases and in 33.3% of cases of gastritis. Neoplasms were identified at laparoscopy in 2 additional cases (0.8%).
CONCLUSIONS
Surgeons and pathologists should be aware of the high prevalence of diagnoses requiring clinical follow-up in vertical sleeve gastrectomy specimens.
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