Beware Pathological Findings of the Stomach in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis

被引:0
|
作者
Shiqi Wang
Quan Wang
Lei Xu
Pengfei Yu
Qin Li
Xiaohua Li
Man Guo
Bo Lian
Gang Ji
机构
[1] Fourth Military Medical University,Department of Gastrointestinal Surgery, Xijing Hospital of Digestive Diseases, Xijing Hospital
[2] Peking University,Laboratory of Surgical Oncology, Peking University People’s Hospital
[3] Xi’an Hospital of Traditional Chinese Medicine,Department of Biomedical Engineering, School of Life Science and Technology
[4] Xi’an Jiaotong University,undefined
来源
Obesity Surgery | 2021年 / 31卷
关键词
Bariatric surgery; Obese; Pathology; Stomach lesion;
D O I
暂无
中图分类号
学科分类号
摘要
Abnormal anatomic findings are a major concern before performing bariatric surgery, while pathological changes are considered less often. The present study aimed to investigate the incidences of gastric lesions warranting follow-up in patients undergoing bariatric surgery. Meta-analyses were conducted to calculate the pooled incidences of gastric lesions in patients undergoing bariatric surgery. Fifty-nine studies including 32,789 patients were included: 26 on endoscopic biopsy, 26 on pathological findings of the excised specimen, five on the intraoperative exploration results, and two on both preoperative endoscopy and postoperative specimen. Generally, atrophic gastritis (3.05% (95% CI (confidence interval) 1.53–6.09)), intestinal metaplasia (2.44% (95% CI 1.76–3.25)), and GIST (gastrointestinal stromal tumor) (0.45% (95% CI 0.31–0.60)) were not rarely found. Routine preoperative endoscopy was applied in 16 studies, and the pooled incidences of atrophic gastritis and intestinal metaplasia were 2.64% (95% CI 0.78–8.9) and 2.70% (95% CI 0.9–5.42), respectively. Hp. (Helicobacter pylori) screening and eradication were routinely performed in 10 studies, and that was related to a reduced incidence of atrophic gastritis (0.94% (95% CI 0.03–2.92)) vs. 4.31% (95% CI 2.01–9.23). GIST was more likely to be found by intraoperative exploration than by preoperative endoscopy (0.68% (95% CI 0.50–0.93) vs. 0.23% (95% CI 0.11–0.52)). Patients undergoing bariatric surgery demonstrated non-negligible incidences of gastric pathologies warranting follow-up. Preoperative endoscopy and careful intraoperative exploration should be routinely performed, and Hp. screening and eradication are suggested before endoscopy. In condition that such findings are detected, sleeve gastrectomy may be preferred over Roux-en-Y gastric bypass.
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页码:337 / 342
页数:5
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