Anıl Ergin1, Hüseyin Çiyiltepe2, Aziz Bora Karip3, Mehmet Mahir Fersahoğlu2, Nuriye Esen Bulut2, Ahmet Çakmak2, Berk Topaloğlu2, Ali Cihan Bilgili2, Adnan Somay4, İksan Taşdelen2, Ümit Akyüz5, Kemal Memişoğlu2. 1. General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, Hastane Street No: 1/8 Icerenkoy, 34752, Istanbul, Turkey. dranilergin@gmail.com. 2. General Surgery Department, Fatih Sultan Mehmet Training and Research Hospital, Hastane Street No: 1/8 Icerenkoy, 34752, Istanbul, Turkey. 3. General Surgery Department, Istanbul Oncology Hospital, Cevizli Mah. Toros Street No:86 Maltepe, Istanbul, Turkey. 4. Pathology Department, Fatih Sultan Mehmet Training and Research Hospital, Hastane Street No: 1/8 Icerenkoy, 34752, Istanbul, Turkey. 5. Gastroenterology Department, Fatih Sultan Mehmet Training and Research Hospital, Hastane Street No: 1/8 Icerenkoy, 34752, Istanbul, Turkey.
Abstract
PURPOSE: The most important cause affecting the thickness of the gastric wall other than the tumor is chronic gastritis caused by Helicobacter pylori (Hp), which is most frequently detected in the antrum. This study aims to investigate the effect of bismuth-based treatment (BBT) combined with proton pump inhibitor (PPI) on wall thicknesses measured in the postoperative gastric specimen and early postoperative complications in patients with Hp-positive pre-LSG endoscopic gastric biopsies. MATERIALS AND METHODS: The patients who underwent LSG procedure for morbid obesity were divided into three groups as follows: Hp-negative, Hp-positive without eradication treatment, and Hp-positive, and LSG was performed after eradication treatment. Macroscopic and microscopic gastric wall thickness measurements were made at a distance of 1 cm from the proximal surgical margin, from the middle part of the specimen, and 1 cm from the distal surgical margin in the gastric specimen and the results were compared. RESULTS: A total of 132 patients were included in the study, 44 patients in each group. Microscopically measured antrum mucosal thickness was found to be statistically significantly higher in group 2 compared to other groups (groups 1.15, 1.35, 1.16 mm, respectively, p = 0.000). There was no difference between the groups in terms of early complications such as bleeding, wound site infection, or leakage from the staple line within the first 28 days after surgery. CONCLUSION: This study found that LSG had no effect on early complications due to Hp positivity or eradication of Hp. KEY POINTS: • The presence of HP increases the wall thickness of the gastric antrum mucosa. • After HP eradication, stomach antrum wall thickness returns to normal. • HP eradication before LSG reduces the wall thickness of the gastric antrum mucosa. • It was determined that HP scanning and eradication before LSG had no effect on postoperative complications.
PURPOSE: The most important cause affecting the thickness of the gastric wall other than the tumor is chronic gastritis caused by Helicobacter pylori (Hp), which is most frequently detected in the antrum. This study aims to investigate the effect of bismuth-based treatment (BBT) combined with proton pump inhibitor (PPI) on wall thicknesses measured in the postoperative gastric specimen and early postoperative complications in patients with Hp-positive pre-LSG endoscopic gastric biopsies. MATERIALS AND METHODS: The patients who underwent LSG procedure for morbid obesity were divided into three groups as follows: Hp-negative, Hp-positive without eradication treatment, and Hp-positive, and LSG was performed after eradication treatment. Macroscopic and microscopic gastric wall thickness measurements were made at a distance of 1 cm from the proximal surgical margin, from the middle part of the specimen, and 1 cm from the distal surgical margin in the gastric specimen and the results were compared. RESULTS: A total of 132 patients were included in the study, 44 patients in each group. Microscopically measured antrum mucosal thickness was found to be statistically significantly higher in group 2 compared to other groups (groups 1.15, 1.35, 1.16 mm, respectively, p = 0.000). There was no difference between the groups in terms of early complications such as bleeding, wound site infection, or leakage from the staple line within the first 28 days after surgery. CONCLUSION: This study found that LSG had no effect on early complications due to Hp positivity or eradication of Hp. KEY POINTS: • The presence of HP increases the wall thickness of the gastric antrum mucosa. • After HP eradication, stomach antrum wall thickness returns to normal. • HP eradication before LSG reduces the wall thickness of the gastric antrum mucosa. • It was determined that HP scanning and eradication before LSG had no effect on postoperative complications.
Authors: Raul J Rosenthal; Alberto Aceves Diaz; Dag Arvidsson; Randal S Baker; Nicola Basso; Drake Bellanger; Camilo Boza; Haicam El Mourad; Michael France; Michel Gagner; Manoel Galvao-Neto; Kelvin D Higa; Jacques Himpens; Colleen M Hutchinson; Moises Jacobs; John O Jorgensen; Gregg Jossart; Muffazal Lakdawala; Ninh T Nguyen; David Nocca; Gerhard Prager; Alfons Pomp; Almino Cardoso Ramos; Raul J Rosenthal; Shashank Shah; Michel Vix; Alan Wittgrove; Natan Zundel Journal: Surg Obes Relat Dis Date: 2011-11-10 Impact factor: 4.734
Authors: Frank Benedix; Diana D Benedix; Christian Knoll; Rudolf Weiner; Christiane Bruns; Thomas Manger; Christine Stroh Journal: Obes Surg Date: 2014-10 Impact factor: 4.129