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Published on: November 14, 2020
Unanticipated findings at bariatric surgery
David Greenbaum1, David Friedel
1Lourdes Medical Center of Burlington County, Willingboro, New Jersey 18046, USA. drthin@aol.com
Summary
Obesity increases intra-abdominal cancer risk. Pre-bariatric surgery evaluation, particularly of ovaries in women, can detect significant pathology, improving patient outcomes.
Area of Science:
- Bariatric Surgery
- Surgical Oncology
- Obesity Medicine
Background:
- Obesity is linked to higher rates of intra-abdominal cancers.
- Lack of consensus exists on screening for these malignancies in morbidly obese patients.
- No guidelines address pre-bariatric surgery screening or intraoperative examination for these cancers.
Purpose of the Study:
- To determine the incidence of unexpected intra-abdominal pathology in patients undergoing gastric bypass surgery.
- To assess the value of intraoperative examination prior to bariatric procedures.
Main Methods:
- Prospective analysis of 400 patients (362 women, 38 men) undergoing gastric bypass.
- All patients had abdominal exploration before surgery.
Main Results:
- Abnormalities were detected in 31 (8%) of 400 patients.
- Ovarian abnormalities accounted for 25 of the detected issues.
- Only 3 cases (appendiceal carcinoid, ovarian tumors) had significant prognostic implications if left undiagnosed.
Conclusions:
- Evaluating ovaries in all female patients before weight-loss surgery is recommended.
- Intraoperative exploration can reveal significant pathology missed by standard screening.