Incidental Pathological Findings Detected in Sleeve Gastrectomy Specimens

Baris D Yildiz, MD. ANKARA NUMUNE TEACHING HOSPITAL

Introduction: Sleeve gastrectomy is a popular surgical technique for the treatment of obesity. There are different approaches for the preoperative work up of patients undergoing sleeve gastrectomy when the neccessity of preoperative upper endoscopy is considered.

Methods and Patients: We retrospectively evaluated pathological specimens of 85 patients who had sleeve gastrectomy between 2011 and 2015 performed by the same surgeon. Demographical data, histological findings, pathological findings, postoperative complications were gathered for analysis.

Results: There were 2 cases with gastrointestinal stromal tumor detected in surgical specimens. The rate of Helicobacter pylori was 70%. One specimen contained an active ulcer. This patient had a major postoperative leak which resulted in prolonged hospital stay and eventually total gastrectomy. There was not any adenocancer pathology detected in specimens.

Conclusions: Low rate of accompanying pathologies in our patient group might argue against routine preoperative endoscopy for patients planned to undergo sleeve gastrectomy. But additional studies should be done to reach a concluison about preoperative endoscopy when other conditions such as hiatal hernia or reflux  are considered. It might be worthwhile testing our patient population for Helicobacter pylori preoperatively for probable treatment planning. If preoperative endoscopy shows an active ulcer it might be wise to treat the ulcer before the surgery.

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