Trends in bariatric surgery and incidentalomas at a single institution in Saudi Arabia: a retrospective study and literature review

Can Incidental Gastric GISTs During Bariatric Surgeries Change the Primary Plan of Surgery? A Single Team Experience and a Systematic Review of Literature

As bariatric surgeries (BS) increase, more incidental findings are liable to be discovered. Incidental gastric gastrointestinal stromal tumors (GISTs) during BS can be found in around 0.7% of the cases. In this article, we have performed a systematic review of the literature and added our data to those of the review to review a conceptual treatment strategy to both improve patient outcomes and decrease the risk of overall cancer. With the rise of new bariatric techniques, we have proposed a new classification to BS to enhance our description of the treatment strategy.

Predictive factors and model validation of post-colon polyp surgery Helicobacter pylori infection

BACKGROUND

Recently, research has linked Helicobacter pylori (H. pylori) stomach infection to colonic inflammation, mediated by toxin production, potentially impacting colorectal cancer occurrence.

AIM

To investigate the risk factors for post-colon polyp surgery, H. pylori infection, and its correlation with pathologic type.

METHODS

Eighty patients who underwent colon polypectomy in our hospital between January 2019 and January 2023 were retrospectively chosen. They were then randomly split into modeling (n = 56) and model validation (n = 24) sets using R. The modeling cohort was divided into an H. pylori-infected group (n = 37) and an H. pylori-uninfected group (n = 19). Binary logistic regression analysis was used to analyze the factors influencing the occurrence of H. pylori infection after colon polyp surgery. A roadmap prediction model was established and validated. Finally, the correlation between the different pathological types of colon polyps and the occurrence of H. pylori infection was analyzed after colon polyp surgery.

RESULTS

Univariate results showed that age, body mass index (BMI), literacy, alcohol consumption, polyp pathology type, high-risk adenomas, and heavy diet were all influential factors in the development of H. pylori infection after intestinal polypectomy. Binary multifactorial logistic regression analysis showed that age, BMI, and type of polyp pathology were independent predictors of the occurrence of H. pylori infection after intestinal polypectomy. The area under the receiver operating characteristic curve was 0.969 [95% confidence interval (95%CI): 0.928-1.000] and 0.898 (95%CI: 0.773-1.000) in the modeling and validation sets, respectively. The slope of the calibration curve of the graph was close to 1, and the goodness-of-fit test was P > 0.05 in the two sets. The decision analysis curve showed a high rate of return in both sets. The results of the correlation analysis between different pathological types and the occurrence of H. pylori infection after colon polyp surgery showed that hyperplastic polyps, inflammatory polyps, and the occurrence of H. pylori infection were not significantly correlated. In contrast, adenomatous polyps showed a significant positive correlation with the occurrence of H. pylori infection.

CONCLUSION

Age, BMI, and polyps of the adenomatous type were independent predictors of H. pylori infection after intestinal polypectomy. Moreover, the further constructed column-line graph prediction model of H. pylori infection after intestinal polypectomy showed good predictive ability.

The effect of bariatric surgery on dietary Behaviour, dietary recommendation Adherence, and micronutrient deficiencies one year after surgery

Bariatric surgery (BS) is associated with vitamin and mineral deficiencies, which might be augmented by low adherence to dietary guidelines and inappropriate dietary behaviours. The aim of this study was to determine the influence of BS on eating behaviour, prevalence of nutrient deficiency, level of commitment to diet, and lifestyle recommendations one-year post-BS. A cross-sectional study was conducted among adult patients who underwent BS in 2019 and had follow-up for a year. Age, gender, and clinical data were collected from the hospital system and other information was obtained from questionnaires during phone interviews. A total of 160 patients participated in the study. At 12 months, a significant increase from the baseline values in plasma levels of vitamin B12, folate, vitamin D, iron, corrected calcium, albumin, CRP, and MCV, as well as a significant decrease in BMI was observed. Adherence to dietary and lifestyle recommendations was moderate to high. Emotional, and restrained eating behaviours were moderate with 64.4%, and 77.5%, respectively. External eating was low at 58.1%. The study concluded that pre-and post-bariatric surgery nutrients should be closely monitored.

Prevalence of Dumping Syndrome and Its Determinants Among Post-Bariatric Surgery Adult Patients at King Fahad General Hospital, Jeddah, 2019-2020

Background Bariatric surgery is one of the most effective interventions for morbid obesity. Despite its benefits, unwanted consequences such as dumping syndrome (DS) have been reported following the procedure. This study aims to estimate the prevalence of DS and identify the factors associated with it in Saudi Arabia. Methodology This cross-sectional study collected data from patients who underwent bariatric surgery at King Fahad General Hospital, Jeddah, Saudi Arabia, in 2019-2020. A validated questionnaire was used to collect the data. The questionnaire included demographic items such as age and sex and items relating to DS such as nausea, vomiting, and palpitations. A modified version of the Sigstad diagnostic scoring system was used to confirm the diagnosis. Results Of the 240 investigated cases, two-thirds (67.5%) were females. The most reported symptoms were nausea (37.9%), vomiting (36.7%), desire to lie down (25.5%), restlessness (25.5%), and abdominal fullness (23.7%). Based on the modified Sigstad diagnostic scoring system, 75 (31.4%) patients met the criteria for DS. The bivariate analysis showed the prevalence was significantly higher in females (36.4%), those with university qualifications (40.3%), and those with high monthly income (62.5%) (p<0.05). Also, dietary behaviors in terms of frequency, size of meals, and drinking liquids with meals were significantly associated with the prevalence of DS, where the lowest prevalence was recorded among those who ate more than one small meal (10.9%), while the highest prevalence was found in those who ate more than one large meal (81.8%); also, the prevalence was significantly higher in patients who drank liquids with meals (40.8%) than those who drank liquids between meals (26.8%) (p<0.05). Conclusion In this single institutional study, we report a 31.4% prevalence of DS among our cohort. The predictors of the syndrome include gender, education level, monthly income, eating more than one large meal per day, and drinking liquids with meals. In the future, these predictors will be explained to patients before and after bariatric surgery to reduce the prevalence of such inconvenient syndromes.