The Effect of Bariatric Surgery on Premalignant Endometrial Pathology in Morbidly Obese Patients

To investigate the effect of bariatric surgery on premalignant endometrial pathology in postmenopausal morbidly obese patients. Material and Methods: Between 2014 and 2019, in "Ponderas" Academic Hospital six postmenopausal morbidly obese patients with premalignant endometrial pathology were submitted to bariatric surgery consisting of sleeve gastrectomy. Results: At the time of bariatric surgery, the mean body mass index (BMI) value was of 43.5 kg/m2 (range = 41.5 kg/m2 - 48.5 kg/m2) while the mean age was of 61 years (range = 58 - 63 years). The preoperative biopsy of the endometrial lining demonstrated the presence of simple endometrial hyperplasia in five cases and complex endometrial hyperplasia in one case while the mean thickness of the endometrial lining at magnetic resonance imaging (MRI) was of 2.1 cm (range = 1.5 - 2.8 cm). At one year follow-up, the mean BMI was of 26.5 kg/m2 (range = 24 kg/m2 - 28 kg/m2) while the mean thickness estimated at MRI was of 0.8 cm (range = 0.5 - 1.1 cm). The biopsy demonstrated the presence of normal endometrium in four cases and simple hyperplasia in two cases. Conclusions: Bariatric surgery seems to have an important effect on premalignant endometrial conditions. Therefore, bariatric surgery and consecutive weight loss might decrease the risk of malignant transformation in postmenopausal morbidly obese women.