PDF(Pubmed)
Abstract：
BACKGROUND: Obesity is closely associated with upper gastrointestinal disorders. The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) before bariatric surgery remains a topic of debate. This study aimed to describe the pathological endoscopic findings in individuals qualified for bariatric surgery.
METHODS: Retrospective analysis was conducted on preoperative gastroscopy reports of patients who underwent bariatric surgery at our hospital between October 2022 and October 2023.
RESULTS: A total of 405 patients were included in the study. The two most prevalent endoscopic findings during EGD in this patient cohort were chronic superficial gastritis (326/405, 80.5%) and reflux esophagitis (82/405, 20.2%). Some patients exhibited two or more abnormalities. Patients with reflux esophagitis were older, had a higher proportion of men, higher BMI, higher rates of smoking and drinking compared to those without it (P = 0.033, P < 0.001, P = 0.003, P = 0.001, and P = 0.003, respectively). Morbid obesity (P = 0.037), smoking habits (P = 0.012), and H. pylori infection (P = 0.023) were significant risk factors for reflux esophagitis in male patients, while age (P = 0.007) was the sole risk factor in female patients. No statistically significant differences were observed in surgical procedures between LA-A and B groups (P = 0.382), but statistically significant differences were noted between the nondiabetic and diabetic groups (P < 0.001).
CONCLUSIONS: Preoperative EGD can unveil a broad spectrum of pathologies in patients with obesity, suggesting the need for routine examination before bariatric surgery. The findings of this study can guide bariatric surgeons in developing tailored treatments and procedures, thus significantly enhancing prognosis. Gastroscopy should be performed routinely in Chinese patients planning to undergo bariatric surgery.
METHODS: Retrospective analysis was conducted on preoperative gastroscopy reports of patients who underwent bariatric surgery at our hospital between October 2022 and October 2023.
RESULTS: A total of 405 patients were included in the study. The two most prevalent endoscopic findings during EGD in this patient cohort were chronic superficial gastritis (326/405, 80.5%) and reflux esophagitis (82/405, 20.2%). Some patients exhibited two or more abnormalities. Patients with reflux esophagitis were older, had a higher proportion of men, higher BMI, higher rates of smoking and drinking compared to those without it (P = 0.033, P < 0.001, P = 0.003, P = 0.001, and P = 0.003, respectively). Morbid obesity (P = 0.037), smoking habits (P = 0.012), and H. pylori infection (P = 0.023) were significant risk factors for reflux esophagitis in male patients, while age (P = 0.007) was the sole risk factor in female patients. No statistically significant differences were observed in surgical procedures between LA-A and B groups (P = 0.382), but statistically significant differences were noted between the nondiabetic and diabetic groups (P < 0.001).
CONCLUSIONS: Preoperative EGD can unveil a broad spectrum of pathologies in patients with obesity, suggesting the need for routine examination before bariatric surgery. The findings of this study can guide bariatric surgeons in developing tailored treatments and procedures, thus significantly enhancing prognosis. Gastroscopy should be performed routinely in Chinese patients planning to undergo bariatric surgery.
摘要：
背景：肥胖与上消化道疾病密切相关。减重手术前常规术前食管胃十二指肠镜检查（EGD）的建议仍然是一个争论的话题。这项研究旨在描述符合减肥手术资格的个体的病理内窥镜检查结果。
方法：对2022年10月至2023年10月在我院接受减肥手术的患者的术前胃镜报告进行回顾性分析。
结果：总共405名患者被纳入研究。在该患者队列中，EGD期间最常见的两种内镜检查结果是慢性浅表性胃炎（326/405，80.5%）和反流性食管炎（82/405，20.2%）。一些患者表现出两种或两种以上的异常。反流性食管炎患者年龄较大，男性比例较高，BMI较高,与没有吸烟和饮酒的人相比，吸烟和饮酒的比例更高（分别为P=0.033，P<0.001，P=0.003，P=0.001和P=0.003）。病态肥胖(P=0.037),吸烟习惯（P=0.012），和幽门螺杆菌感染(P=0.023)是男性患者反流性食管炎的显著危险因素,而年龄（P=0.007）是女性患者的唯一危险因素。LA-A组和B组之间的手术操作无统计学差异（P=0.382）。但在非糖尿病组和糖尿病组之间有统计学显著性差异(P<0.001).
结论：术前EGD可以揭示肥胖患者的广泛病理，建议在减肥手术前进行常规检查。这项研究的结果可以指导减肥外科医生制定量身定制的治疗方法和程序，从而显著提高预后。计划接受减肥手术的中国患者应常规进行胃镜检查。
方法：对2022年10月至2023年10月在我院接受减肥手术的患者的术前胃镜报告进行回顾性分析。
结果：总共405名患者被纳入研究。在该患者队列中，EGD期间最常见的两种内镜检查结果是慢性浅表性胃炎（326/405，80.5%）和反流性食管炎（82/405，20.2%）。一些患者表现出两种或两种以上的异常。反流性食管炎患者年龄较大，男性比例较高，BMI较高,与没有吸烟和饮酒的人相比，吸烟和饮酒的比例更高（分别为P=0.033，P<0.001，P=0.003，P=0.001和P=0.003）。病态肥胖(P=0.037),吸烟习惯（P=0.012），和幽门螺杆菌感染(P=0.023)是男性患者反流性食管炎的显著危险因素,而年龄（P=0.007）是女性患者的唯一危险因素。LA-A组和B组之间的手术操作无统计学差异（P=0.382）。但在非糖尿病组和糖尿病组之间有统计学显著性差异(P<0.001).
结论：术前EGD可以揭示肥胖患者的广泛病理，建议在减肥手术前进行常规检查。这项研究的结果可以指导减肥外科医生制定量身定制的治疗方法和程序，从而显著提高预后。计划接受减肥手术的中国患者应常规进行胃镜检查。
