From Bariatric to Oncological Surgery : The Role of Routine Preoperative Upper Endoscopy in Bariatric Surgery (original) (raw)

Indications for upper gastrointestinal endoscopy before bariatric surgery: a multicenter study

Surgical Endoscopy

Background The role of preoperative upper gastrointestinal endoscopy before bariatric surgery is still debated, and a consensus among the international scientific community is lacking. The aims of this study, conducted in three different geographic areas, were to analyze data regarding the pathological endoscopic findings and report their impact on the decision-making process and surgical management, in terms of delay in surgical operation, modification of the intended bariatric procedure, or contraindication to surgery. Methods This is a multicenter cross-sectional study using data obtained from three prospective databases. The preoperative endoscopic reports, patient demographics, Body Mass Index, type of surgery, and Helicobacter pylori status were collected. Endoscopic findings were categorized into four groups: (1) normal endoscopy, (2) abnormal findings not requiring a change in the surgical approach, (3) clinically important lesions that required a change in surgical manageme...

Preoperative upper endoscopy and bariatric surgeries

2018

Objectives In this study, the frequency rate of incidental findings in esophageal and gastric endoscopy of morbid obese subjects’ candidate for bariatric surgery was determined. Methods and Materials In this observational study, 1663 consecutive patients candidate for bariatric obesity in Rasool-Akram Hospital were enrolled and the upper endoscopy was done and the frequency rate of incidental findings was determined. Results In this study, 41, 31, 27.3, 6, 0.8, 0.8% respectively had Helicobacter pylori infection, hiatal hernia, esophagitis, esophageal ulcer, gastric ulcer and polyp. Esophagitis and esophageal ulcer were significantly more common among male subjects (9% males, 5% females and 33% males, 25% females) and the mean age was higher among those with esophageal ulcer and H. pylori infection (P = 0.01 and 0.007 respectively). In general it can be concluded that about 1/3 of patients (35%) with morbid obesity have incidental findings on endoscopy. Conclusion Totally, according...

Prevalence of Upper Gastrointestinal Pathology in Patients with Obesity on Preoperative Endoscopy

JSLS, 2020

Background and Objectives:The preoperative work up for bariatric surgery is variable and not all centers perform a preoperative upper gastrointestinal endoscopy. A study was undertaken to determine the frequency of clinically significant gross endoscopic and pathological diagnoses in a large sample of patients with obesity undergoing work-up for bariatric surgery.Methods:Routine endoscopy was performed on all preoperative bariatric patients. A retrospective chart review of 1000 consecutive patients was performed. Patients were divided into three groups: Group A (no endoscopic findings), Group B (clinically insignificant findings), Group C (clinically significant findings).Results:Patients had a mean body mass index (BMI) of 49 kg/m2 and 79% were female. In this sample one finding was found on preoperative EGD in 95.2% of patients, 33.9% had at least two diagnoses, and 29.9% had three or more diagnoses. Group A (no findings) consisted of 4.8% of patient, 52.5% in Group B (clinically insignificant findings), and 42.7% were in Group C (clinically significant findings). Clinically significant findings included hiatal hernia 23.5%, esophagitis 9.5%, H. pylori 7.1%, gastric erosions 5.7%, duodenitis 3.7%, Barrett's esophagus 3.1%, and Schatzki ring 1.2%. There was no significant correlation between preoperative BMI and any endoscopic findings (all p-value 0.05). Patients in Group C were statistically older than Groups A and B.Conclusion:Upper gastrointestinal pathology is highly common in patients with obesity. There is a significant rate of clinically significant endoscopy findings and all bariatric surgery patients should undergo preoperative endoscopy.