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Background <p>The clinical relevance of routine histopathological examination of sleeve gastrectomy specimens remains controversial.</p> Objective <p>To evaluate the prevalence of histopathological findings, their association with <i>Helicobacter pylori</i>, and potential implications for clinical management.</p> Methods <p>Retrospective cross-sectional study including 1,475 patients undergoing sleeve gastrectomy (2014–2024) at a tertiary referral center in Brazil. Histopathological findings were classified according to the Updated Sydney System. Associations were analyzed using Poisson regression variance.</p> Results <p>Inflammatory changes were observed in 55.1% of specimens, predominantly mild gastritis (73.2%). <i>H. pylori</i> was detected in 7.3%. Premalignant lesions were rare: atrophic gastritis (0.3%), intestinal metaplasia (0.6%), and one adenocarcinoma (0.07%). <i>H. pylori</i> was independently associated with gastritis (adjusted PR ranging from approximately 15 to 18, <i>p</i> &lt; 0.001) and severity (<i>p</i> &lt; 0.001). No association was observed with age or sex. Intestinal metaplasia was associated with age (<i>p</i> = 0.024).</p> Conclusions <p>Histopathological abnormalities are common but predominantly mild. Clinically significant lesions are rare. Routine histopathological evaluation may detect unexpected findings in selected cases, but its universal role in risk stratification remains unclear.</p>

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Histopathological Findings in Sleeve Gastrectomy Specimens: Prevalence, Determinants, and Clinical Implications in a Large Brazilian Cohort

  • 期刊论文

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  • 发表日期：

    2026年6月30日

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  • Marina de Oliveira Menezes,
  • Luiz Henrique Bandeira de Andrade Lima Filho,
  • Luciana Teixeira de Siqueira,
  • José Guido Corrêa de Araujo Júnior,
  • Júlia Maria Mendes Lins,
  • Álvaro Antônio Bandeira Ferraz

摘要

Background

The clinical relevance of routine histopathological examination of sleeve gastrectomy specimens remains controversial.

Objective

To evaluate the prevalence of histopathological findings, their association with Helicobacter pylori, and potential implications for clinical management.

Methods

Retrospective cross-sectional study including 1,475 patients undergoing sleeve gastrectomy (2014–2024) at a tertiary referral center in Brazil. Histopathological findings were classified according to the Updated Sydney System. Associations were analyzed using Poisson regression variance.

Results

Inflammatory changes were observed in 55.1% of specimens, predominantly mild gastritis (73.2%). H. pylori was detected in 7.3%. Premalignant lesions were rare: atrophic gastritis (0.3%), intestinal metaplasia (0.6%), and one adenocarcinoma (0.07%). H. pylori was independently associated with gastritis (adjusted PR ranging from approximately 15 to 18, p < 0.001) and severity (p < 0.001). No association was observed with age or sex. Intestinal metaplasia was associated with age (p = 0.024).

Conclusions

Histopathological abnormalities are common but predominantly mild. Clinically significant lesions are rare. Routine histopathological evaluation may detect unexpected findings in selected cases, but its universal role in risk stratification remains unclear.