Gastric Mucosal Changes following Gastroplasty: A Comparative Study Between Vertical Banded Gastroplasty and Silastic Ring Vertical Gastroplasty

BACKGROUND: Long-term changes of gastric mucosa following surgery for morbid obesity have never been studied, to the best of our knowledge. As 31 patients in our series presented with various gastrointestinal complaints following surgery, we used this opportunity to study mucosal changes. METHODS: Thirty-seven gastroscopies were performed on 31 patients, 20 patients following Vertical Banded Gastroplasty (VBG) and 11 patients following Silastic Ring Vertical Gastroplasty (SRVG) with various gastrointestinal complaints. Macroscopic appearance of the gastric mucosa was examined and biopsies taken from the proximal gastric pouch, the transitional zone and distal stomach. RESULTS: In most patients, macroscopic appearance of the proximal and distal pouches was normal. Pathological findings were mainly located in the transitional zone and were found mainly in the VBG group. CONCLUSIONS: This study indicates that damage to the gastric mucosa is related to the surgical technique, and mainly to the strip of mesh used in the VBG patients. Since hyperplasia and metaplasia were among the microscopic findings, a question is raised about the possibility of malignant transformation. We suggest that routine post-operative gastroscopies be considered, especially following VBG.

Diagnosis of carcinoma of the breast by fine needle aspiration cytology

During a six year period, 1,953 fine needle aspiration cytologies (FNAC) were performed for lumps of the breast. Of these, 355 were diagnosed as carcinoma of the breast. The FNAC was performed on an outpatient basis and the pathologic interpretation was available within 30 to 60 minutes. The treatment strategy was always guided by the clinical impression of the physician. If the results of a suspected mass were negative on FNAC, biopsy was performed and histologic study gave the final diagnosis. There were no false-positive results and only 6 per cent were false-negative findings diagnosed later by open biopsy. The over-all accuracy rate was 90 per cent plus 4 per cent diagnosed on cytologic examination as "suspicious" and which proved to be malignant. Based upon our accumulated results, simplicity of performing the test, its low cost, the extremely low morbidity, the immediate response and, above all, an over-all high accuracy rate, we conclude that FNAC is a highly recommended method for the diagnosis of carcinoma of the breast.