垂直袖状胃切除术标本中意外组织病理学发现的发生率很高，需要额外的临床处理。
Vertical sleeve gastrectomy specimens have a high prevalence of unexpected histopathologic findings requiring additional clinical management.
作者信息
Raess Philipp W, Baird-Howell Marilyn, Aggarwal Rajesh, Williams Noel N, Furth Emma E
机构信息
Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
出版信息
Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1020-3. doi: 10.1016/j.soard.2015.01.002. Epub 2015 Jan 9.
BACKGROUND
Laparoscopic vertical sleeve gastrectomy is used with increasing frequency as a therapeutic option for morbid obesity. Before the procedure, patients undergo a rigorous preoperative evaluation including double contrast upper gastrointestinal radiographic series at our institution. Patients undergoing sleeve gastrectomy are presumed to have no significant gastric pathology.
OBJECTIVES
To investigate the prevalence of histopathologic findings requiring clinical follow-up in sleeve gastrectomy specimens.
SETTING
University Hospital, United States.
METHODS
Retrospective review was conducted of all primary vertical sleeve gastrectomy specimens performed for morbid obesity at our institution from July 2008 until August 2012 (N = 248).
RESULTS
Unanticipated findings warranting clinical follow-up were identified in 8.4% of cases and included cases of H. pylori gastritis, autoimmune gastritis with microcarcinoid formation, necrotizing vasculitis, and intestinal metaplasia. H. pylori was identified in 5.2% of all cases and in 33.3% of cases of gastritis. Neoplasms were identified at laparoscopy in 2 additional cases (0.8%).
CONCLUSIONS
Surgeons and pathologists should be aware of the high prevalence of diagnoses requiring clinical follow-up in vertical sleeve gastrectomy specimens.
背景
腹腔镜垂直袖状胃切除术作为治疗病态肥胖的一种选择，其应用频率日益增加。在手术前，患者在我们机构要接受严格的术前评估，包括双重对比上消化道造影系列检查。接受袖状胃切除术的患者被认为没有明显的胃部病变。
目的
调查袖状胃切除标本中需要临床随访的组织病理学发现的发生率。
地点
美国大学医院。
方法
对2008年7月至2012年8月在我们机构因病态肥胖进行的所有原发性垂直袖状胃切除标本进行回顾性研究（N = 248）。
结果
8.4%的病例发现了需要临床随访的意外发现，包括幽门螺杆菌胃炎、伴有微类癌形成的自身免疫性胃炎、坏死性血管炎和肠化生。所有病例中5.2%发现幽门螺杆菌，胃炎病例中33.3%发现幽门螺杆菌。另外2例（0.8%）在腹腔镜检查时发现肿瘤。
结论
外科医生和病理学家应意识到垂直袖状胃切除标本中需要临床随访的诊断发生率很高。
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