Zacharakis Georgios, Almasoud Abdulaziz, AlZahrani Jamaan, Al-Ghamdi Sameer, Altuwaim Abdullah, AlShehri Abdullah, Bawazir Abdullah, Alonazi Ahmad, Alsamari Faisal, Alajmi Mohammed, Lotfy Ahmed, Kyritsis Alexandros, Nikolaidis Pavlos, Terzis Ioannis
Endoscopy Unit, Department of Medicine, Prince Sattam bin Abdulaziz University Hospital, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj (Georgios Zacharakis, Abdullah Altuwaim, Abdullah Bawazir, Ahmad Alonazi, Faisal Alsamari, Mohammed Alajmi).
Endoscopy Unit, Prince Sultan Military Medical City, Riyadh (Abdulaziz Almasoud).
Ann Gastroenterol. 2021;34(2):177-182. doi: 10.20524/aog.2021.0576. Epub 2021 Jan 16.
Preoperative esophagogastroduodenoscopy (EGD) may affect the management of bariatric patients although this is not consistent universally. The present prospective study evaluated the effect of preoperative EGD findings in obese Saudi patients, including upper digestive symptoms (UDS) and comorbidities, on their planned surgery.
From January 2018 to May 2019, we conducted a 4-center retrospective observational study to evaluate the endoscopic findings among Saudi patients aged 18-65 years with a body mass index (BMI) >40 kg/m. Preoperative data included UDS, comorbidities, () infection assessed during a histopathological examination, and EGD findings.
717 patients underwent EGDs, and 432 underwent bariatric surgery. The mean BMI was 44.3±6.3 kg/m, and the mean age was 27.8±11.8 years. The overall UDS prevalence was 49%, with the most frequent being gastroesophageal reflux disease 54% (387/717), followed by dyspepsia 44% (315/717). infection was detected in 287/672 (42.4%) patients. The total percentage of patients with normal EGD was 36% (258/717). A delayed bariatric procedure was performed in 15% of the patients for the following reasons: 2.3% had large polyps of >1 cm (either hyperplastic or cystic polyps); 1.62% had esophagitis grade C and D based on the Los Angeles classification; 0.7% had Barrett's esophagus; and 5.7% had peptic ulcer disease.
Our findings confirmed that obesity carries a profound health burden with a significant impact on health expenditures. Routine preoperative EGD in the obese Saudi population appears to be mandatory to identify factors that may change, delay, or postpone the bariatric procedure.
术前食管胃十二指肠镜检查（EGD）可能会影响肥胖症患者的治疗管理，尽管并非普遍如此。本前瞻性研究评估了术前EGD检查结果对沙特肥胖患者（包括上消化道症状（UDS）和合并症）计划手术的影响。
2018年1月至2019年5月，我们进行了一项4中心回顾性观察研究，以评估18 - 65岁、体重指数（BMI）>40 kg/m²的沙特患者的内镜检查结果。术前数据包括UDS、合并症、组织病理学检查期间评估的（）感染以及EGD检查结果。
717例患者接受了EGD检查，432例接受了减肥手术。平均BMI为44.3±6.3 kg/m²，平均年龄为27.8±11.8岁。UDS总体患病率为49%，最常见的是胃食管反流病54%（387/717），其次是消化不良44%（315/717）。在287/672（42.4%）例患者中检测到（）感染。EGD检查结果正常的患者总百分比为36%（258/717）。15%的患者因以下原因进行了延迟减肥手术：2.3%有直径>1 cm的大息肉（增生性或囊性息肉）；1.62%根据洛杉矶分类有C级和D级食管炎；0.7%有巴雷特食管；5.7%有消化性溃疡病。
我们的研究结果证实，肥胖带来了沉重的健康负担，对医疗支出有重大影响。在沙特肥胖人群中进行常规术前EGD检查似乎是必要的，以识别可能改变、延迟或推迟减肥手术的因素。
