Camelia Doina VRABİE, Manole COJOCARU, Maria WALLER, Ruxandra SİNDELARU, Catalin COPAESCU

Tüp gastrektomi yapılan obez hastalardaki ana histopatolojik lezyonlar

Amaç: Obezite prevalansı son on yıllarda gelişmiş ülkelerde artmaktadır. Hafif ve orta obezite çeşitli morbidite ile birliktedir. Obezitenin ağır formları çeşitli sağlık problemleri ile birliktedir. Bu çalışmanın amacı tüp gastrektomi ile elde edilen dokudaki histopatolojik lezyonları araştırmak ve analiz etmektir. Yöntemler: Ekim 2007 ile haziran 2008 arasında tüp gastrektomi uygulanan 87 cerrahi girişimden elde edilen dokular incelendi. Tüm doku örnekleri (mide, karaciğer, yağ dokusu) Patoloji bölümünde incelendi. Doku örnekleri formalinde fiske edilerek hematoksieln eozinle boyandı. Bulgular: Kadın/erkek oranı 2/1 idi. Yaşları 31-40 arasında olan geç hastalar en sık etkilenmişti (%39.1). Sık rastlanan histopatolojik lezyonlar pariyetal hücre hiperplazisi (%63.2), ülserasyonlar (%34.5), lamina propriada lenf nodu hiperplazisi (%33.3), aktif gastrit (%23.0) ve diğer lezyonlar (%10.3) oranlarında saptandı. Mide forniks ve korpus mukozasındaki pariyetal hücre hiperplazisi obez hastalarda en sık rastlanan lezyon idi. Karaciğer biyopsi yapılan üç hastada hepatositlerde steatozis saptandı. Sonuç: Bizim sonuçlarımız obez hastalarda mide forniks mukoza ve karaciğer gibi diğer dokuların histopatolojik analizi ko-morbiditelerle birlikte bulundu. Obez hastalardaki gastrik ve karaciğer lezyonların histopatolojik incelenmesi lokal mekanizmaları ve hastaların sonuçlarını daha iyi anlamaya yardımcı olabilir.

Anahtar Kelimeler:

Ağır obezite, tüp gastrektomi, histopatoloji, lezyonlar

The main histopathological gastric lesions in obese patients who underwent sleeve gastrectomy

Objectives: The prevalence of obesity has been increasing in recent decades in developed countries. Slight and moderate obesity is associated with various co-morbidities. The most severe forms of obesity are consistently associated with the development of various health problems. The aim of this study was to investigate and analyze the most important histopathological lesions obtained by sleeve gastrectomy postoperatively. Materials and methods: We investigated 87 surgical interventions, performed between October of 2007 and June of 2008 for bariatric therapy procedures, using sleeve gastrectomy. All the specimens (gastric, liver and adipose tissue) were processed in the Pathology Department. The specimens were fixed in buffered formalin, and then stained with hematoxilin eosin. Results: The female to male ratio was 2/1. Young patients aged between 31-40 years were most frequently (39.1%) affected. The frequent histopathological lesions were parietal cells hyperplasia (63.2%), ulcerations (34.5%), lymph nodes hyperplasia in lamina propria (33.3%), active gastritis (23.0%) and other lesions (10.3%). The parietal cells hyperplasia found in fornix and corpus mucosa was the most frequent lesion encountered in obese patients. All three cases showed an important steatosis of the hepatocytes by liver biopsy. Conclusions: Our results suggest that the histopathology analysis of the gastric mucosa of the fornix and other tissues (as the liver) is relevant for the comorbidities of the obese patients. The evaluation of the histopathological gastric and liver aspects could improve the understanding of the local mechanism and the outcome of the patients.

Keywords:

Morbid obesity, sleeve gastrectomy, histopathology, lesions,

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