Should laparoscopic sleeve gastrectomy specimens be examined histopathologically? Experience of two hundred forty-six patients in university hospital

INTRODUCTION: Laparoscopic sleeve gastrectomy has become an increasingly common practice in recent years.In this method,about 1000-1100ml stomach is resected.In the case reports or case series,incidental malignant lesions have been reported.The aim of this study was to evaluate the histopathologic results of patients,undergoing laparoscopic sleeve gastrectomy and to discuss the factors affecting the development of malignant lesions. METHODS: In accordance with the criteria of the World Health Organization,LSG surgeries were performed in246 consecutive patients between January2013and October2017 in a single academic center.Prospectively recorded medical data of these patients were retrospectively reviewed. RESULTS: 72.4% of the patients were female.The average BMIwas 45,4kg/m2. The most common pathological finding was gastritis.Three patients had incidental malignancy,two patients had atrophic gastritis and extensive intestinal metaplasia.These malign lesions could not be detected in the preoperative evaluations of patients. DISCUSSION AND CONCLUSION: In recent years there has been a significant increase in the number of bariatric operations performed for elderly patients.In spite of"the older age"was not found as a risk factor for malignancy in our study,the incidence of malignancy in older people is higher than that of younger individuals.Due to increasing of the elderly patient, the malignant lesions may increase.If these lesions have a small size or they locate at subserosa, they may not be detected in preoperative examinations. Even if no pathologic findings are found in the preoperative endoscopic evaluation,the anterior and posterior wall of the stomach should be fully mobilized to look for possible subserosal lesions in LSG procedure.Histopathologic examination of all gastric specimens should be performed for potential incidental occult malignancies