Trends in bariatric surgery and incidentalomas at a single institution in Saudi Arabia: a retrospective study and literature review

Abstract

BACKGROUND: Data are lacking on trends in bariatric surgery and the frequency of incidental findings in Saudi Arabia. OBJECTIVE: Report on trends in bariatric surgery as well as our experience in incidental findings along with a literature review (mainly on gastrointestinal stromal tumor). DESIGN: Retrospective chart and literature review. SETTINGS: Academic tertiary care center. PATIENTS AND METHODS: We conducted a retrospective study at King Khalid University Hospital and analyzed the data collected from 2009 to 2019. We collected data on age, body mass index (BMI), H pylori infection, type of bariatric surgery performed, and type and location of incidental findings. MAIN OUTCOME MEASURES: Incidental findings during or after bariatric surgery (in pathology specimen). SAMPLE SIZE: 3052 bariatric surgeries, 46 patients with incidentalomas. RESULTS: The mean and standard deviation for the age of the 46 patients with incidentalomas was 42.1 (13.9) years and the mean (SD) preoperative BMI was 43.4 (6.4) kg/m 2 . Of 3052 bariatric surgeries performed, the most common type was sleeve gastrectomy (93.9%), followed by gastric bypass surgery (4.58%) and gastric banding (1.47%). The total frequency of incidentalomas was 1.5%; 10.8% of patients had gastrointestinal stromal tumors (GIST), with the stomach being the commonest site for incidental findings. Eighty percent of the patients with GIST were positive for H pylori ( P =.01 vs negative patients). CONCLUSION: The number of incidentalomas and other findings were consistent with other reports. All these findings suggest that bariatric surgeons should take special care before, during, and after a laparoscopic operation in obese patients. LIMITATIONS: Since this is a single-center, retrospective study, we did not collect data on important variables such as gender, socioeconomic status of the patient, and family history of obesity, and we did not perform a preoperative esophagogastroduodenoscopy. CONFLICT OF INTEREST: None.

Prevalence of Dumping Syndrome and Its Determinants Among Post-Bariatric Surgery Adult Patients at King Fahad General Hospital, Jeddah, 2019–2020

“…Obesity is a prevalent progressive health problem in Saudi Arabia and bariatric surgery has been recognized to be on the rise as a preferred choice for long-term reduction of weight [ 12 , 13 ]. Studies indicate that DS is a typical side effect of bariatric surgery, with little information about its exact frequency and factors associated with it in different settings [ 13 ].…”

“…Obesity is a prevalent progressive health problem in Saudi Arabia and bariatric surgery has been recognized to be on the rise as a preferred choice for long-term reduction of weight [ 12 , 13 ]. Studies indicate that DS is a typical side effect of bariatric surgery, with little information about its exact frequency and factors associated with it in different settings [ 13 ]. Therefore, the current study aimed at exploring the prevalence of DS and associated factors in patients who have undergone bariatric surgery in one of the main general hospitals in Jeddah, Saudi Arabia.…”

Predictive factors and model validation of post-colon polyp surgery Helicobacter pylori infection

“…Thus patients with adenomatous polyps on polyp pathology had a greater likelihood of H. pylori infection. It has been reported in the literature[ 16 , 17 ] that this can be because there is an association between BMI and H. pylori infection, and that the two factors can interact with each other. Due to the long-term intake of excessively high calories, the immune environment of their organs is changed, which leads to the expansion of adipose tissues and the activation of macrophages through the secretion of chemokines, subsequently causing a localized inflammatory response.…”

The effect of bariatric surgery on dietary Behaviour, dietary recommendation Adherence, and micronutrient deficiencies one year after surgery

“…( Gudzune et al, 2013 ) RYGB and LSG are the two most common bariatric procedures in Saudi Arabia. ( AlAli et al, 2020 ) Prior research has demonstrated LSG’s utility for treating morbid obesity. ( Aldaqal and Sehlo, 2013 , Ahmed et al, 2017 ) Despite the significant weight loss and reduction of comorbid conditions which follow BS, there are complications and nutritional risks associated with these procedures.…”