Evaluating the Necessity of Routine Histopathology in Sleeve Gastrectomy Specimens: A Five-Year Analysis.

Autor:	Khattak MA; Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR., Rafique AM; Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR., Iqbal Y; Acute and General Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, GBR., Abdulrasheed H; Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR., Khan MU; Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR., Malik A; Urology, Northampton General Hospital, Northampton, GBR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 18; Vol. 16 (9), pp. e69666. Date of Electronic Publication: 2024 Sep 18 (Print Publication: 2024).
DOI:	10.7759/cureus.69666
Abstrakt:	Introduction: Laparoscopic sleeve gastrectomy (LSG) is a widely performed bariatric surgery that involves the removal of a portion of the stomach. Routinely, the resected gastric tissue is sent for histopathological examination to screen for malignancies or other significant pathological findings. However, the necessity of this routine practice remains uncertain. This study aims to evaluate the histopathological outcomes of LSG specimens over a five-year period at our institution. Methods: We conducted a retrospective analysis of 203 patients who underwent LSG between January 2017 and December 2022 at Heartlands Hospital, University Hospitals Birmingham. Data collected included patient demographics, body mass index (BMI), use of preoperative oesophagogastroduodenoscopy (OGD), and histopathological findings. Patients with incomplete records or those who underwent Roux-en-Y gastric bypass were excluded from the study. Results: Data were extracted for 310 patients, of whom 107 were excluded. The majority of the 203 patients analyzed were female (83%), with a mean age of 45.7 years and a mean BMI of 45.4 ± 7.3. Preoperative OGD was performed in only 0.5% of cases. Histopathological examination revealed that 81.3% (n=165) of patients had normal gastric mucosa, while 14.3% (n=29) had chronic gastritis. Clinically significant findings were rare, with only 1% (n=2) of patients showing gastrointestinal stromal tumors (GISTs) or focal intestinal metaplasia. None of the patients required additional treatment or follow-up based on these histopathological findings. Conclusion: Most LSG specimens in our study showed normal or non-significant histopathological findings, raising questions about the routine use of histopathological examination in LSG procedures. It remains unclear whether histopathology is necessary following sleeve gastrectomy. While no patients in our cohort required further treatment or surveillance, there are reports in the literature where surveillance or further treatment was necessary, though the incidence remains low. Given the low incidence of clinically significant pathology, further studies with larger sample sizes and multi-center data are needed to establish clear guidelines on this issue. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Khattak et al.)
Databáze:	MEDLINE
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