Pathological Review of Resected Gastric Specimens Following Laparoscopic Sleeve Gastrectomy Over Four Years at Two Major Referral Hospitals in Shiraz, Iran

Background: Bariatric surgery is the most effective treatment for morbid obesity, resulting in long-term weight loss and considerable improvements in coexisting conditions. We conducted a histopathologic evaluation of resected stomach specimens after laparoscopic sleeve gastrectomy.Methods: We evaluated the medical records of 827 patients who underwent laparoscopic sleeve gastrectomy between 2015 and 2018 at two major referral hospitals in Shiraz, Iran. In this retrospective study, the pathological findings of resected stomach specimens and other variables such as age, sex, preoperative body mass index (BMI), and comorbid illnesses were evaluated. Results: 653 cases (78.9%) had chronic gastritis in some form; lymphoid follicle formation (in 197 cases), acute on chronic gastritis (in 67 cases), complete intestinal metaplasia (in 5 cases), hyperplastic polyps (in 5 cases), and gastrointestinal stromal tumors (GISTs) (2 cases) were the next most common findings. Most lymphoid follicle formation was reported in the context of gastritis. Two patients with GIST and one with submucosal lymphoma received further treatment.Conclusion: Abnormal histopathologic findings were found in 88% of sleeve gastrectomy specimens. only one case of malignancy was found, less than 15% of samples were completely normal. Results of our study indicate high rate of abnormal pathologies in reseted gastric specimens.