Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens?

Tamer Saafan,Moataz Bashah,Walid El Ansari

doi:10.1007/s11695-019-03801-y

Abstract

BackgroundObesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or pre-malignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes.MethodRetrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens.ResultsFemales comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies.ConclusionWhen confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates.

Highlights

Bariatric procedures are common worldwide as a result of the obesity epidemic [1, 2], and laparoscopic sleeve gastrectomySkövde, Sweden 5 Weill Cornell Medicine, Doha, Qatar (LSG) is a widely practised procedure
Despite that obese patients are at higher risk of many cancers and despite the increased risk of pre-malignant conditions in Laparoscopic sleeve gastrectomy (LSG) histopathology specimens, the literature suggests that very sparse research has been undertaken to explore the associations between be determined if exposure (BMI) and histopathological changes identified in the gastric specimens of LSG patients [10, 17,18,19]
It is important to scrutinise the relationship between BMI and different histopathologies in morbidly obese patients undergoing LSG in order to assess whether higher BMI

Summary

Introduction

Bariatric procedures are common worldwide as a result of the obesity epidemic [1, 2], and laparoscopic sleeve gastrectomySkövde, Sweden 5 Weill Cornell Medicine, Doha, Qatar (LSG) is a widely practised procedure. The aim of the current study was to examine, among LSG patients, the relationship between BMI and different histopathologies identified in the removed gastric specimens. Is the BMI of patients with abnormal specimens (whether benign or pre-malignant) different from the BMI of controls with normal specimens?; 3. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and compared with the BMI of patients with normal control specimens. After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies

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