Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty
Background The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy...
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| Veröffentlicht in: | Obesity surgery 2013, Vol.23 (1), p.131-139 |
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| creator | Leuratti, Luca Di Simone, Massimo Pierluigi Cariani, Stefano |
| description | Background
The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy with an endoscope of standard size.
Methods
From January 2009 to July 2010, 51 asymptomatic patients at 4 and 5 years follow-up after RYGB-on-VBG submitted to upper endoscopy. All of them were examined with standard endoscopy with collection of biopsies in gastric fundus, body, and antrum. The macroscopic and microscopic findings were analyzed according to Sydney Classification.
Results
The endoscopy of the remnant stomach was technically easy and already showed on macroscopic examination 90 % cases of gastritis (41.2 % mild, 49 % severe) with tendency of severity in the distal stomach part. Histological analysis detected 39.2 % of active gastritis, 50.6 % of quiescent gastritis, 7.8 % of intestinal metaplasia, and 3.9 % of lymphoma-like gastritis.
Conclusions
The results surprised us. We found a very high rate of mucosa abnormalities after RYGB-on-VBG. All of the patients have to be regularly controlled in follow-up and treatment has to be introduced when needed. Again, we would like to ask the question: what is happening with the remnant stomach after standard RYGB, banded gastric bapass, or minigastric bypass? Did we reach the time to answer the question? |
| doi_str_mv | 10.1007/s11695-012-0808-8 |
| format | Article |
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The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy with an endoscope of standard size.
Methods
From January 2009 to July 2010, 51 asymptomatic patients at 4 and 5 years follow-up after RYGB-on-VBG submitted to upper endoscopy. All of them were examined with standard endoscopy with collection of biopsies in gastric fundus, body, and antrum. The macroscopic and microscopic findings were analyzed according to Sydney Classification.
Results
The endoscopy of the remnant stomach was technically easy and already showed on macroscopic examination 90 % cases of gastritis (41.2 % mild, 49 % severe) with tendency of severity in the distal stomach part. Histological analysis detected 39.2 % of active gastritis, 50.6 % of quiescent gastritis, 7.8 % of intestinal metaplasia, and 3.9 % of lymphoma-like gastritis.
Conclusions
The results surprised us. We found a very high rate of mucosa abnormalities after RYGB-on-VBG. All of the patients have to be regularly controlled in follow-up and treatment has to be introduced when needed. Again, we would like to ask the question: what is happening with the remnant stomach after standard RYGB, banded gastric bapass, or minigastric bypass? Did we reach the time to answer the question?</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-012-0808-8</identifier><identifier>PMID: 23129236</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Biliary Tract - pathology ; Clinical outcomes ; Endoscopy, Gastrointestinal ; Female ; Gastric Bypass - methods ; Gastric Mucosa - microbiology ; Gastric Mucosa - pathology ; Gastric Stump - pathology ; Gastritis - microbiology ; Gastritis - pathology ; Gastrointestinal surgery ; Helicobacter Infections - pathology ; Helicobacter pylori ; Humans ; Long term ; Male ; Medicine ; Medicine & Public Health ; Metaplasia - diagnosis ; Middle Aged ; Obesity ; Obesity, Morbid - pathology ; Obesity, Morbid - surgery ; Other ; Severity of Illness Index ; Stomach ; Surgery ; Treatment Outcome ; Weight Loss</subject><ispartof>Obesity surgery, 2013, Vol.23 (1), p.131-139</ispartof><rights>Springer Science+Business Media New York 2012</rights><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-601fc1366a06adea6aa622744b9fe8ec1e9cc4d055589d76df4aed97059baca63</citedby><cites>FETCH-LOGICAL-c372t-601fc1366a06adea6aa622744b9fe8ec1e9cc4d055589d76df4aed97059baca63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-012-0808-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-012-0808-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23129236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leuratti, Luca</creatorcontrib><creatorcontrib>Di Simone, Massimo Pierluigi</creatorcontrib><creatorcontrib>Cariani, Stefano</creatorcontrib><title>Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy with an endoscope of standard size.
Methods
From January 2009 to July 2010, 51 asymptomatic patients at 4 and 5 years follow-up after RYGB-on-VBG submitted to upper endoscopy. All of them were examined with standard endoscopy with collection of biopsies in gastric fundus, body, and antrum. The macroscopic and microscopic findings were analyzed according to Sydney Classification.
Results
The endoscopy of the remnant stomach was technically easy and already showed on macroscopic examination 90 % cases of gastritis (41.2 % mild, 49 % severe) with tendency of severity in the distal stomach part. Histological analysis detected 39.2 % of active gastritis, 50.6 % of quiescent gastritis, 7.8 % of intestinal metaplasia, and 3.9 % of lymphoma-like gastritis.
Conclusions
The results surprised us. We found a very high rate of mucosa abnormalities after RYGB-on-VBG. All of the patients have to be regularly controlled in follow-up and treatment has to be introduced when needed. Again, we would like to ask the question: what is happening with the remnant stomach after standard RYGB, banded gastric bapass, or minigastric bypass? Did we reach the time to answer the question?</description><subject>Biliary Tract - pathology</subject><subject>Clinical outcomes</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Female</subject><subject>Gastric Bypass - methods</subject><subject>Gastric Mucosa - microbiology</subject><subject>Gastric Mucosa - pathology</subject><subject>Gastric Stump - pathology</subject><subject>Gastritis - microbiology</subject><subject>Gastritis - pathology</subject><subject>Gastrointestinal surgery</subject><subject>Helicobacter Infections - pathology</subject><subject>Helicobacter pylori</subject><subject>Humans</subject><subject>Long term</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metaplasia - diagnosis</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - pathology</subject><subject>Obesity, Morbid - surgery</subject><subject>Other</subject><subject>Severity of Illness Index</subject><subject>Stomach</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU9r3DAQxUVoabZJP0AuQdBLLmol2ZatY7LkHwRaQlLoSczK42aDLTuSDNljv3lnu2kohV40YvR7b0Y8xo6U_KSkrD8npYythFRayEY2otljC1XTRZa6ecMW0hopGquLffY-pUcptTJav2P7ulCa2mbBft4HfJ7QZ2z58gHCD0x8HXh-QH4JKce157c4BAh52z5Nm2HK4wCZ-l_pxJAThy5j5Lfj_CwwiO-vwrPNBCnxMfBvGEkBPT-D0NKk38Q49VQ2h-xtB33CDy_1gN1fnN8tr8TNl8vr5emN8EWtszBSdV4VxoA00CIYAPpLXZYr22GDXqH1vmxlVVWNbWvTdiVga2tZ2RV4MMUBO9n5TnF8mjFlN6yTx76HgOOcnNJ1UVbWqILQj_-gj-McA21HlLGltbbWRKkd5eOYUsTOTXE9QNw4Jd02H7fLx1E-bpuPa0hz_OI8rwZsXxV_AiFA74BET5RG_Gv0f11_AbmWnCg</recordid><startdate>2013</startdate><enddate>2013</enddate><creator>Leuratti, Luca</creator><creator>Di Simone, Massimo Pierluigi</creator><creator>Cariani, Stefano</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2013</creationdate><title>Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty</title><author>Leuratti, Luca ; Di Simone, Massimo Pierluigi ; Cariani, Stefano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-601fc1366a06adea6aa622744b9fe8ec1e9cc4d055589d76df4aed97059baca63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Biliary Tract - pathology</topic><topic>Clinical outcomes</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Female</topic><topic>Gastric Bypass - methods</topic><topic>Gastric Mucosa - microbiology</topic><topic>Gastric Mucosa - pathology</topic><topic>Gastric Stump - pathology</topic><topic>Gastritis - microbiology</topic><topic>Gastritis - pathology</topic><topic>Gastrointestinal surgery</topic><topic>Helicobacter Infections - pathology</topic><topic>Helicobacter pylori</topic><topic>Humans</topic><topic>Long term</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metaplasia - diagnosis</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - pathology</topic><topic>Obesity, Morbid - surgery</topic><topic>Other</topic><topic>Severity of Illness Index</topic><topic>Stomach</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leuratti, Luca</creatorcontrib><creatorcontrib>Di Simone, Massimo Pierluigi</creatorcontrib><creatorcontrib>Cariani, Stefano</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leuratti, Luca</au><au>Di Simone, Massimo Pierluigi</au><au>Cariani, Stefano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2013</date><risdate>2013</risdate><volume>23</volume><issue>1</issue><spage>131</spage><epage>139</epage><pages>131-139</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy with an endoscope of standard size.
Methods
From January 2009 to July 2010, 51 asymptomatic patients at 4 and 5 years follow-up after RYGB-on-VBG submitted to upper endoscopy. All of them were examined with standard endoscopy with collection of biopsies in gastric fundus, body, and antrum. The macroscopic and microscopic findings were analyzed according to Sydney Classification.
Results
The endoscopy of the remnant stomach was technically easy and already showed on macroscopic examination 90 % cases of gastritis (41.2 % mild, 49 % severe) with tendency of severity in the distal stomach part. Histological analysis detected 39.2 % of active gastritis, 50.6 % of quiescent gastritis, 7.8 % of intestinal metaplasia, and 3.9 % of lymphoma-like gastritis.
Conclusions
The results surprised us. We found a very high rate of mucosa abnormalities after RYGB-on-VBG. All of the patients have to be regularly controlled in follow-up and treatment has to be introduced when needed. Again, we would like to ask the question: what is happening with the remnant stomach after standard RYGB, banded gastric bapass, or minigastric bypass? Did we reach the time to answer the question?</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>23129236</pmid><doi>10.1007/s11695-012-0808-8</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0960-8923 |
| ispartof | Obesity surgery, 2013, Vol.23 (1), p.131-139 |
| issn | 0960-8923 1708-0428 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Biliary Tract - pathology Clinical outcomes Endoscopy, Gastrointestinal Female Gastric Bypass - methods Gastric Mucosa - microbiology Gastric Mucosa - pathology Gastric Stump - pathology Gastritis - microbiology Gastritis - pathology Gastrointestinal surgery Helicobacter Infections - pathology Helicobacter pylori Humans Long term Male Medicine Medicine & Public Health Metaplasia - diagnosis Middle Aged Obesity Obesity, Morbid - pathology Obesity, Morbid - surgery Other Severity of Illness Index Stomach Surgery Treatment Outcome Weight Loss |
| title | Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty |
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