For a study, it was determined that before vertical sleeve gastrectomy, esophagogastroduodenoscopy (EGD) was frequently done to assess for mucosal and structural abnormalities (SG). However, nothing was known about how pre-bariatric EGD in adolescents affected clinical care or outcome. Researchers wanted to determine if a faulty pre-bariatric EGD resulted in interventions or changes to bariatric surgery. A retrospective cohort study of teenagers receiving bariatric surgery assessment was carried out. In addition to EGD results, biopsy pathology, gastrointestinal symptoms, and surgical outcomes, researchers collected demographic and anthropometric data. An EGD was judged abnormal if it revealed either abnormal gross findings or abnormal pathology. Patients were followed up on until a 6-week postoperative visit.
Preoperative EGD was performed on 94 (70%) of 134 patients that came in for assessment. About 51 (54%) had a normal EGD, whereas 43 (46%) had EGD abnormalities, including 7 with anatomical abnormalities and 36 with minor mucosal abnormalities. Proton pump inhibitor (PPI) medication (n=10) and Helicobacter pylori eradication (n=11) were given to 22% of patients with EGD abnormalities. The sole predictor of EGD abnormalities was gastrointestinal symptoms (odds ratio [OR] 4.9: 95% CI 1.6–15.0; P<0.001). A post-EGD intervention was not predicted by any of the parameters. An aberrant EGD did not appear to be related to any surgical problems.
In the group of teenagers being evaluated for SG, 46% had an abnormal EGD, and 22% got medical treatment. EGD abnormalities could only be predicted by symptoms. Abnormal EGD results were not linked to operation modifications or any negative outcomes.
Reference:journals.lww.com/jpgn/Fulltext/2019/09000/Upper_Gastrointestinal_Endoscopy_in_Adolescents.4.aspx
