• Natl Med J India · Mar 2019

    Is histopathological examination of sleeve gastrectomy specimens necessary in areas endemic for gastric cancer?

    • Santosh Anand, Raja Kalayarasan, Sandip Chandrasekar, Pazhanivel Mohan, Biju Pottakkat, and Senthil Gnanasekaran.
    • Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Puducherry 605006, India.
    • Natl Med J India. 2019 Mar 1; 32 (2): 83-85.

    BackgroundThe value of histopathological examination of a laparoscopic sleeve gastrectomy (LSG) specimen in areas endemic for Helicobacter pylori (H. pylori) and gastric cancer is not known. We assessed the histopathological findings of LSG specimens to determine whether routine histopathological examination of these would be useful in patients with normal preoperative upper gastrointestinal endoscopy findings in an area endemic for gastric cancer.MethodsWe did a retrospective analysis of the histopathological findings of LSG specimens in patients who underwent the procedure between March 2015 and March 2017. We ascertained the association of positive histopathological findings with the clinical profile of patients and preoperative upper gastrointestinal endoscopy findings.ResultsTwenty-six patients (16 females) with a mean age of 37.5 years underwent LSG during the study period. On preoperative upper gastrointestinal endoscopy, 18 patients had unremarkable findings. Of the three patients with gastric or duodenal erosions on upper gastrointestinal endoscopy, two had H. pylori infection. On histopathological examination, 14 patients had unremarkable findings. Chronic gastritis with or without follicle formation was the most common finding (n=7). None of the patients with normal upper gastrointestinal endoscopy findings had significant histopathological findings or evidence of H. pylori infection. No significant association was found between age, gender, body mass index, smoking and alcohol intake with positive histopathological findings (p=0.64, 0.91, 0.90, 0.10 and 0.94, respectively).ConclusionsWe did not find clinically important histopathological findings on routine examination of the LSG specimen in bariatric patients with normal preoperative upper gastrointestinal endoscopy findings.

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