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Routine preoperative endoscopy in patients undergoing bariatric surgery
Victoria C Chang1, Ping Pan1, Shinil K Shah2
1Division of Minimally Invasive and Elective General Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas; UT Physicians, The Davis Clinic at Memorial Hermann-Memorial City Medical Center, Houston, Texas.
Summary
Routine preoperative endoscopy before weight loss surgery is debated. This study found significant abnormal findings, even in asymptomatic patients, impacting surgical plans, suggesting selective screening may miss critical pathology.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Surgical Oncology
Background:
- The necessity of routine preoperative endoscopy before bariatric surgery is a subject of ongoing debate.
- Evaluating the frequency of abnormal findings is crucial for patient management.
Purpose of the Study:
- To determine the incidence of abnormal findings during routine preoperative endoscopy in patients undergoing primary bariatric surgery.
- To assess the impact of endoscopic findings on planned surgical procedures.
Main Methods:
- Retrospective chart review of 631 patients undergoing primary bariatric surgery between July 2014 and June 2016.
- Analysis of pre-endoscopy symptoms, endoscopic findings (esophagitis, hiatal hernia, Barrett's esophagus), and subsequent changes in surgical plans.
Main Results:
- 61.3% of patients lacked pre-endoscopy symptoms.
- Common abnormal findings included esophagitis (26.5%) and hiatal hernia (27.1%).
- 18.4% of patients experienced a change in their planned bariatric surgery based on endoscopy results.
Conclusions:
- Routine preoperative endoscopy identified significant foregut pathology, even in asymptomatic individuals.
- Selective screening based solely on symptoms may lead to missed diagnoses and impact surgical planning.
- Further research is needed to validate these findings and guide clinical practice.
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