Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, School of Medicine, Iran University of Medical Sciences.
Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran.
Surg Laparosc Endosc Percutan Tech. 2022 Oct 1;32(5):549-553. doi: 10.1097/SLE.0000000000001097.
We evaluated the relationship between comorbidities associated with obesity, body mass index (BMI), and development of intestinal metaplasia (IM) after vertical sleeve gastrectomy (VSG).
All VSG specimens performed at an academic center between 2011 and 2018 were reviewed. All specimens underwent histopathologic assessment, while those with findings suspicious for IM underwent additional immunohistochemical work up. Baseline patient characteristics and demographic data were obtained from Iran National Obesity Surgery Database by retrospective review.
A total of 862 adult individuals underwent VSG during the study period and specimens were histopathologically examined. All patients had preoperative upper endoscopy. The most common histopathologic diagnosis was miscellaneous findings (57.8%) followed by no pathologic finding (36.7%). The minority of patients (5.5%) had IM. Although 40.5% of patients had positive Helicobacter pylori infection preoperatively, just 13.8% had still positive infection postoperatively. A significant association was found between IM and hypercholesterolemia (odds ratio: 1.95; 95% confidence interval: 1.1, 3.5).
This study found a correlation between histopathologic changes in patients with IM and hypercholesterolemia. Prospective research studies are recommended to further examine this correlation.
我们评估了与肥胖相关的合并症、体重指数(BMI)与垂直袖状胃切除术(VSG)后肠上皮化生(IM)发展之间的关系。
回顾了 2011 年至 2018 年在学术中心进行的所有 VSG 标本。所有标本均进行了组织病理学评估,对于有 IM 可疑发现的标本,进行了额外的免疫组织化学检查。通过回顾性研究,从伊朗国家肥胖手术数据库中获得了基线患者特征和人口统计学数据。
在研究期间,共有 862 名成年人接受了 VSG 手术,对标本进行了组织病理学检查。所有患者术前均进行了上消化道内镜检查。最常见的组织病理学诊断是其他发现(57.8%),其次是无病理发现(36.7%)。少数患者(5.5%)有 IM。尽管术前 40.5%的患者存在幽门螺杆菌感染,但术后仍有 13.8%的患者存在感染。IM 与高胆固醇血症之间存在显著相关性(比值比:1.95;95%置信区间:1.1,3.5)。
本研究发现了 IM 患者的组织病理学变化与高胆固醇血症之间的相关性。建议进行前瞻性研究进一步研究这种相关性。