Histopathologic findings in laparoscopic sleeve gastrectomy: is routine full pathologic evaluation indicated?

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Surgical Pathology

Background:

• Laparoscopic sleeve gastrectomy (SG) is the most frequent bariatric procedure.
• Gastric specimens are routinely sent for pathology, but no national guidelines mandate this.
• This study presents one of the largest histopathologic series for SG patients.

Purpose of the Study:

• To investigate if a specific patient subgroup in the northeastern US is more prone to clinically significant findings in SG specimens.
• To evaluate the benefit of routine histopathologic examination of gastric sleeves.

Main Methods:

• Retrospective analysis of electronic health records from 3543 SG patients at an academic institution.
• Review of patient demographics, BMI, and histopathology reports of resected gastric sleeves.

Main Results:

• 1076 patients (30.4%) had abnormal pathologies, including gastritis, intestinal metaplasia, and rare malignancies.
• Black and Hispanic patients showed a higher incidence of gastrointestinal stromal tumors and intestinal metaplasia.
• Helicobacter pylori infection was more common in specimens with abnormal findings.

Conclusions:

• Routine pathology evaluation of all SG specimens may be questioned.
• Targeted histopathologic analysis could be beneficial for specific patient groups, such as older Black and Hispanic individuals in the northeastern US.