BACKGROUND Laparoscopic Sleeve Gastrectomy (LSG) is nowadays an established bariatric procedure . Although preoperative gastroscopy is recommended to rule out severe pathologies, there is little evidence about the role of routine histopathologic examination of resected specimens . We sought to identify the prevalence of histopathological relevant findings in patients undergoing LSG and to evaluate their impact in clinical practice .
METHODS A retrospective analysis on a prospectively collected dataset on patients undergoing LSG between August 2009 and May 2018 in two bariatric centers was performed . Demographic and clinical data and histopathological results were analyzed .
RESULTS Sixhundred-thrirteen patients were identified, mean age was 43.1 years (14-75), average body mass index was 44.8 kg/m (34.4-73.9). Histopathology revealed abnormal findings in 47.97% of the patients, most common pathology was chronic non-active or minimally to moderate active gastritis (= 202; 32.95 %). Among others, Helicobacter-associated gastritis (= 33; 5.38 %), intestinal metaplasia (= 13; 2.12 %), micronodular enterochromaffine-like cell hyperplasia (= 2; 0.33 %) and gastrointestinal stromal tumors (= 6; 0.98 %) were present . No malignancies were found . Histopathological results required a change in the postoperative management in 48 patients (7.83 %). The costs of histopathological assessment ranged between 0.77% and 2.55% of per-case payment .
CONCLUSION A wide range of histopathological findings occur in specimens after LSG, requiring a relevant number of patients additional therapies or surveillance . Therefore, routine histopathological examination after LSG is recommendable.