沙特阿拉伯西部地区接受腹腔镜袖状胃切除术的肥胖患者的组织病理学发现。

Histopathological findings in obese patients undergoing laparoscopic sleeve gastrectomy in the Western region of Saudi Arabia.

作者信息

Saharti Samah, Aljohani Reem

机构信息

From the Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

From the Department of Pathology, Temple University Hospital, Philadelphia, Pennsylvannia, United States.

出版信息

Ann Saudi Med. 2025 Jul-Aug;45(4):218-224. doi: 10.5144/0256-4947.2025.218. Epub 2025 Aug 7.

DOI:10.5144/0256-4947.2025.218

PMID:40753463

Abstract

BACKGROUND

Metabolic and bariatric surgeries are effective interventions in reducing weight and mortality. Laparoscopic sleeve gastrectomy is the most commonly performed procedure, particularly in the Middle East and North Africa (MENA) region. It involves resection of approximately 80% of the stomach, yielding large specimens for histopathological evaluation.

OBJECTIVES

To identify histopathological findings in gastric specimens, evaluate the incidence of unexpected gastrointestinal stromal tumors (GISTs), and characterize the metabolic and bariatric surgery population in Saudi Arabia.

DESIGN

Retrospective cohort.

SETTINGS

Single-center tertiary care in Saudi Arabia.

PATIENTS AND METHODS

The study included patients who underwent laparoscopic gastric sleeve between May 2015 and April 2021. Inclusion criteria were patients with BMI ≥ 30 kg/m who underwent surgery as treatment for obesity.

MAIN OUTCO ME MEASURES

Gastric histopathological findings, unexpected GIST incidence and metabolic and bariatric surgery population.

SAMPLE SIZE

211 patients with obesity.

RESULTS

Patients' mean age was 38.2 years with a mean Body mass index (BMI) of 44.24 kg/m. The majority were females (60.2%). Normal histology findings accounted for 43.1% of findings, followed by chronic inactive gastritis (35.5%). Intestinal metaplasia was found in 1 (0.5%) patient while incidental GIST was found in 2 (0.9%) patients. was identified in 12.8% of cases, with a mean patient age of 36.7 years. Among -positive patients, 48% presented with chronic active gastritis, 33% with chronic inactive gastritis, 14.8% with active follicular gastritis, and 3.7% with inactive follicular gastritis. A history of prior endoscopy was noted in 16.1% of patients, of whom 11.76% were found to have postoperatively.

CONCLUSIONS

H. pylori infection was detected at a mean age of 36.7 years and showed a significant association with higher BMI (mean difference: 2.2 kg/m, =.04). While this suggests a potential link between obesity and susceptibility, the clinical significance of this small absolute difference requires further investigation. remained strongly associated with follicular gastritis (=.003) but showed no difference between males and females.

LIMITATIONS

Retrospective design and Giemsa stain was not done for all specimens to investigate .

摘要

背景

代谢性和减重手术是减轻体重和降低死亡率的有效干预措施。腹腔镜袖状胃切除术是最常施行的手术，特别是在中东和北非（MENA）地区。该手术涉及切除约80%的胃，从而获得用于组织病理学评估的大标本。

目的

确定胃标本的组织病理学发现，评估意外胃肠道间质瘤（GIST）的发生率，并描述沙特阿拉伯代谢性和减重手术人群的特征。

设计

回顾性队列研究。

地点

沙特阿拉伯的单中心三级医疗中心。

患者和方法

该研究纳入了2015年5月至2021年4月期间接受腹腔镜袖状胃切除术的患者。纳入标准为BMI≥30kg/m²且接受手术治疗肥胖症的患者。

主要观察指标

胃组织病理学发现、意外GIST发生率以及代谢性和减重手术人群。

样本量

211例肥胖患者。

结果

患者的平均年龄为38.2岁，平均体重指数（BMI）为44.24kg/m²。大多数为女性（60.2%）。正常组织学发现占发现结果的43.1%，其次是慢性非活动性胃炎（35.5%）。1例（0.5%）患者发现肠化生，2例（0.9%）患者发现偶然的GIST。12.8%的病例中检测到幽门螺杆菌，患者平均年龄为36.7岁。在幽门螺杆菌阳性患者中，48%表现为慢性活动性胃炎，33%表现为慢性非活动性胃炎，14.8%表现为活动性滤泡性胃炎，3.7%表现为非活动性滤泡性胃炎。16.1%的患者有既往内镜检查史，其中11.76%术后被发现有幽门螺杆菌感染。