Endoscopic and histopathological assessment of individuals undergoing one anastomosis gastric bypass: a 2-year follow-up.

Autor: Braga JGR; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Callejas GH; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., da Silva Costa LC; Unit of Digestive Endoscopy, State University of Campinas (UNICAMP), Campinas, Brazil., Montes CG; Unit of Digestive Endoscopy, State University of Campinas (UNICAMP), Campinas, Brazil., Chaim FDM; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Gestic MA; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Utrini MP; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Callejas-Neto F; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Ramos AC; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Chaim EA; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil., Cazzo E; Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brasil. notrevezzo@yahoo.com.br.; Rua Alexander Fleming, S/No, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil. notrevezzo@yahoo.com.br.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2023 May; Vol. 37 (5), pp. 3720-3727. Date of Electronic Publication: 2023 Jan 17.
DOI: 10.1007/s00464-023-09884-0
Abstrakt: Background: There is much debate over the occurrence of biliary reflux to the gastric pouch after one anastomosis gastric bypass (OAGB) and its potential risks.
Objective: To assess endoscopic and histopathological findings following a standardized protocol of biopsy collection two years after OAGB.
Methods: A historical cohort study was conducted, based on a prospectively collected database, which involved 39 participants who underwent OAGB. Participants underwent clinical evaluation and esophagogastroduodenoscopy at the time of surgery and 24 months afterward. Post-operatively, biopsy specimens in esophagogastric junction, pouch, and anastomosis were systematically collected.
Results: 92.3% of the participants were female and the mean age was 37 ± 8.5 years. The mean body mass index (BMI) significantly decreased from 37.6 ± 5.7 kg/m 2 to 27 ± 4.1 kg/m 2 after 2 years (p < 0.001). The mean %TWL was 27.2 ± 10.5%. The prevalence of non-erosive gastritis significantly increased from 25.6 to 51.3% (p = 0.02). Erosive gastritis significantly decreased from 28.2 to 10.3% (p = 0.04). Four cases of marginal ulcers were identified (10.3%). The commonest histopathological finding was mild inflammation in 74.3% (esophagogastric junction), 58.9% (pouch), and 71.8% (anastomosis). There was one case of focal intestinal metaplasia in each site of interest and no cases of dysplasia or severe inflammation.
Conclusions: Using a standardized protocol of post-operative biopsy collection, low rates of severe endoscopic and histopathological abnormalities were observed two years after OAGB. Nevertheless, as most patients have histologically proven inflammation, bile in the gastric pouch, and endoscopic gastritis, long-term surveillance is essential because of the uncertain risk of these abnormalities.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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