Incidental pathologic findings in open resectional gastric bypass specimens with routine cholecystectomy and appendectomy

Sohn, Vance Y.; Arthurs, Zachary M.; Martin, Matthew J.; Sebesta, James A.; Branch, James B.; Champeaux, Anne L.

doi:10.1016/j.soard.2008.01.015

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…Among 427 gastric specimens from open gastric bypass Sohn et al [22] found only chronic gastritis, 1 leiomyoma and 1 cyst. The authors suggested performing a microscopic evaluation depending on the intraoperative view rather than making it a routine procedure.…”

Section: Discussionmentioning

confidence: 99%

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Różańska-Walędziak

Kowalewski

Janik

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionObesity is one of the major lifestyle diseases and provokes various comorbidities, such as hypertension, type 2 diabetes mellitus, obstructive sleep apnea, and even neoplasms. Bariatric surgery is the most effective treatment of obesity. Since cost-effectiveness has become a major concern, there is a tendency to avoid general histological evaluation of surgical specimens during routine procedures.AimTo evaluate the necessity of histopathological investigation of tissue excised during bariatric surgery and to verify whether the operation should be continued in the case of suspicious macroscopic findings.Material and methodsFrom January 2013 to December 2016, 1252 patients with obesity were qualified for bariatric procedures. The qualification was performed according to the current European recommendations. Every operation started with an inspection of the peritoneal cavity performed once the abdomen was insufflated. If a macroscopic pathology was found, the specimen was secured for histopathological investigation.ResultsOut of 81 (6.47%) patients from whom histopathological samples were collected, 39% (n = 32) showed negative results, and 61% (n = 49) cases showed abnormalities.ConclusionsAs it is impossible to exclude the existence of gastric tumors only in preoperative gastroscopy and ultrasonography, especially as there is a higher risk in obese patients, routine histological examination of tissue excised during bariatric procedures should be considered. Since most of the neoplasms were found to be benign, there is no need to abandon the bariatric procedure if a pathology is found and resected. Bariatric surgeons should always focus on thorough examination of the abdominal and the pelvic cavity, especially in female patients.

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Section: Discussionmentioning

confidence: 99%

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Różańska-Walędziak

Kowalewski

Janik

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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“…15 Keshishian et al 56 reported a 1.5% incidence of small bowel carcinoids. Sohn et al 52 found no pathological evidence of carcinoids on examination of 427 stomach remnants, which were routinely resected during RYGB.…”

Section: Methodsmentioning

confidence: 99%

“…Studies (40 in number, Table 1 3–5,19–21,23–26,28,29,31–42,46–48,52,56,58–60,63,71–73,76,77,81 describing the occurrence and management of various cancers, benign and premalignant conditions, in patients undergoing bariatric surgery were retrieved. These reports accounted for a total of 570 patients.…”

Section: Methodsmentioning

confidence: 99%

“…Sohn et al 52 who examined the distal part of the stomach that was resected routinely during RYGB, found that intestinal metaplasia was present in about 0.7% of the stomachs. De Moura et al 53 who performed gastric biopsy during endoscopy in 36 patients as demanded by endoscopic findings in a series of 162 patients, found that intestinal metaplasia was present in about 11% of the patients who had a biopsy.…”

Section: Methodsmentioning

confidence: 99%

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Benign, Premalignant, and Malignant Lesions Encountered in Bariatric Surgery

Rs¹,

Kini²

2012

JSLS

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“…Incidental findings on histological examination of pathology specimens are not uncommon, and are most frequently encountered in specimens from elective procedures, such as reduction mammoplasty and gastric bypass . These findings generally occur in the primary organ of interest.…”

Section: Introductionmentioning

confidence: 99%

Incidental splenic findings in pancreatosplenectomy specimens resected for primary pancreatic lesions

et al. 2019

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Aims Little has been written on the frequency and nature of incidental splenic lesions diagnosed on histopathological examination of pancreatosplenectomy specimens. Methods and results For 191 such specimens, incidental histological findings after haematopathologist re‐review were tabulated. Cases suspicious for lymphoid malignancy underwent molecular analysis for immunoglobulin heavy and kappa light chain rearrangement. Follow‐up was obtained on selected cases. In five cases (3%), the spleen was sampled but not mentioned in the original microscopic report; all were normal on re‐review. Otherwise, most (171 of 186, 92%) were initially diagnosed as normal, with 160 (94%) remaining so on re‐review. Findings on re‐review not initially described (n = 11, 6%) included four cases with splenic morphology suspicious for possible leukaemia/lymphoma involvement. Additional findings included abscess formation, foamy macrophages, necrotising granulomas and simple cysts. Fifteen spleens were initially diagnosed as abnormal; the histopathological process was confirmed in all, including non‐necrotising granulomas, cysts, Gamna–Gandy bodies, foamy macrophages, involvement by pancreatic neoplasm and involvement by known chronic lymphocytic leukaemia (CLL). Molecular analysis was performed on the five cases of known/suspected lymphoma and two were positive for monoclonal gene rearrangement, including the known CLL and a previously undiagnosed case with similar immunophenotype. Conclusions Incidental splenic findings are not uncommon in pancreatosplenectomy specimens. While most are of limited clinical significance, low‐grade lymphoproliferative disorders may go undetected if the spleen is overlooked. We recommend careful observation of splenic findings in these specimens, with a low threshold for haematopathological consultation when in doubt.

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Incidental pathologic findings in open resectional gastric bypass specimens with routine cholecystectomy and appendectomy

Cited by 15 publications

References 20 publications

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Benign, Premalignant, and Malignant Lesions Encountered in Bariatric Surgery

Incidental splenic findings in pancreatosplenectomy specimens resected for primary pancreatic lesions

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