Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 1/2024

07-06-2023 | Colonoscopy | Original Article

Clinical significance of colonoscopy before laparoscopic bariatric/metabolic surgery in Japanese patients

Authors: Masayuki Ohta, Yuichi Endo, Hidefumi Shiroshita, Takahide Kawasaki, Takashi Masuda, Teijiro Hirashita, Kensuke Fukuda, Ryo Ogawa, Kazuhiro Mizukami, Takayuki Masaki, Kazunari Murakami, Masafumi Inomata

Published in: Surgery Today | Issue 1/2024

Login to get access

Abstract

Purpose

Obesity is known to be associated with colorectal adenoma (CRA) and colorectal cancer (CRC); yet colonoscopy is not considered an essential preoperative evaluation before bariatric/metabolic surgery. The aim of this study was to clarify the clinical significance of preoperative colonoscopy for obese Japanese patients.

Methods

The subjects of this retrospective study were 114 patients who underwent screening colonoscopy before bariatric/metabolic surgery. Multivariate analyses were performed to evaluate the independent predictors of CRA/CRC among the characteristics identified as significant or nearly significant by univariate analyses.

Results

Colonoscopy revealed abnormal findings indicating the need for biopsy or polypectomy in 20 of the 114 patients (17.5%), and CRA was diagnosed in 13 patients (11.4%). Three patients (2.6%), who were all ≥ 56 years old, had a CRA ≥ 10 mm in diameter. The multivariate analysis showed that older age and male sex were significant predictors of CRA/CRC, which was identified in 46.2% of the male patients aged ≥ 46 years.

Conclusion

Our findings suggest that older age and male sex may be risk factors for CRA/CRC in obese Japanese candidates for bariatric/metabolic surgery; thus, preoperative colonoscopy should be considered for these high-risk patients.
Literature
1.
Ben Q, An W, Jiang Y, Zhan X, Du Y, Cai QC, et al. Body mass index increases risk for colorectal adenomas based on meta-analysis. Gastroenterology. 2012;142:762–72.CrossRefPubMed
2.
Okabayashi K, Ashrafian H, Hasegawa H, Yoo JH, Patel VM, Harling L, et al. Body mass index category as a risk factor for colorectal adenomas: a systematic review and meta-analysis. Am J Gastroenterol. 2012;107:1175–85.CrossRefPubMed
3.
Sato Y, Nozaki R, Yamada K, Takano M, Haruma K. Relation between obesity and adenomatous polyps of the large bowel. Dig Endosc. 2009;21:154–7.CrossRefPubMed
4.
Ma Y, Yang Y, Wang F, Zhang P, Shi C, Zou Y, et al. Obesity and risk of colorectal cancer: a systematic Review of prospective studies. PLoS ONE. 2013;8: e53916.CrossRefPubMedPubMedCentral
5.
Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007;86:556–65.CrossRefPubMed
6.
Dash C, Yu J, Nomura S, Lu J, Rosenberg L, Palmer JR, et al. Obesity is an initiator of colon adenoma but not a promoter of colorectal cancer in the Black Women’s Health Study. Cancer Cause Control. 2020;31:291–302.CrossRef
7.
8.
Blackett JW, Verna E, Lebwohl B. Increased prevalence of colorectal adenomas in patients with nonalcoholic fatty liver disease: a cross-sectional study. Dig Dis. 2020;38:222–30.CrossRefPubMed
9.
Dash C, Palmer JR, Boggs DA, Rosenberg L, Adams-Campbell LL. Type 2 diabetes and the risk of colorectal adenomas: black women’s health study. Am J Epidemiol. 2013;179:112–9.CrossRefPubMedPubMedCentral
10.
Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.CrossRefPubMed
11.
ASGE Standard of Practice Committee, Evans JA, Muthusamy VR, Acosta RD, Bruining DH, Chandrasekhara V, et al. The role of endoscopy in the bariatric surgery patient. Surg Obes Relat Dis. 2015; 11:507–17.
12.
Brown WA, Shah YJH, Balalis G, Bashir A, Ramos A, Kow L, et al. IFSO Position Statement on the role of esophago-gastro-duodenal endoscopy prior to and after bariatric and metabolic surgery procedures. Obes Surg. 2020;30:3135–53.CrossRefPubMed
13.
Tarnoff M, Kim J, Shikora S. Patients selection, preoperative assessment, and preparation. In: Schauer PR, Schirmer BD, Brethauer SA, editors. Minimally invasive bariatric surgery. New York: Springer; 2007. p. 57–63.
14.
Ohta M, Kitano S. Preoperative evaluation and preparation for patients. In: Choi SH, Kasama K, editors. Bariatric and metabolic surgery. Heidelberg: Springer; 2014. p. 11–5.CrossRef
15.
Nimeri A, Al Hadad M, Khoursheed M, Maasher A, Al Qahtani A, Al Shaban T, et al. The peri-operative bariatric surgery care in the Middle East region. Obes Surg. 2017;27:1543–7.CrossRefPubMed
16.
Toydemir T, Ozgen G, Çalıkoğlu İ, Ersoy Ö, Yerdel MA. A comparative study evaluating the incidence of colorectal neoplasia(s) in candidates for bariatric surgery by screening colonoscopy, 40–49 versus 50–65 yaers old: a preliminary study. Obes Surg. 2019;29:2430–5.CrossRefPubMed
17.
Sasaki A, Yokote K, Naitoh T, Fujikura J, Hayashi K, Hirota Y, et al. Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity. Diabetol Int. 2022;13:1–30.CrossRefPubMed
18.
Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11:489–506.CrossRefPubMed
19.
Endo Y, Ohta M, Kawamura M, Fujinaga A, Nakanuma H, Watanabe K, et al. Gastric wall thickness and linear staple height in sleeve gastrectomy in Japanese patients with obesity. Obes Surg. 2022;32:349–54.CrossRefPubMed
20.
Ohta M, Ahn SM, Seki Y, Yang W, Wong SKH, Lee J, et al. Ten years of change in bariatric/metabolic surgery in the Asia-Pacific region with COVID-19 pandemic: IFSO-APC National Reports 2021. Obes Surg. 2022;32:2994–3004.CrossRefPubMedPubMedCentral
21.
Fujimoto K, Sakata T, Etou H, Fukunaga K, Ookuma K, Terada K, et al. Charting of daily weight pattern reinforces maintenance of weight reduction in moderately obese patients. Am J Med Sci. 1992;303:145–50.CrossRefPubMed
22.
Naitoh T, Kasama K, Seki Y, Ohta M, Oshiro T, Sasaki A, et al. Efficacy of sleeve gastrectomy with duodenal-jejunal bypass for the treatment of obese severe diabetes patients in Japan: a retrospective multicenter study. Obes Surg. 2018;28:497–505.CrossRefPubMed
23.
24.
25.
Kamo KI, Fukui K, Ito Y, Nakayama T, Katanoda K. How much can screeing reduce colorectal cancer mortality in Japan? Scenario-based estimation by microsimulation. Jpn J Clin Oncol. 2022;52:221–6.CrossRefPubMed
26.
Hotta K, Matsuda T, Kakugawa Y, Ikematsu H, Kobayashi N, Kushima R, et al. Regional colorectal cancer screening program using colonoscopy on an island: a prospective Nii-jima study. Jpn J Clin Oncol. 2017;47:118–22.CrossRefPubMed
27.
Niikura R, Hirata Y, Suzuki N, Yamada A, Hayakawa Y, Suzuki H, et al. Colonoscopy reduces colorectal cancer mortality: a multicenter, long-term, colonoscopy-based cohort study. PLoS ONE. 2017;12: e0185294.CrossRefPubMedPubMedCentral
28.
Kawamura T, Oda Y, Murakami Y, Kobayashi K, Matsuda K, Kida M, et al. Relationship between frequency of surveillance colonoscopy and colorectal cancer prevention. Dig Endosc. 2014;26:409–16.CrossRefPubMed
29.
Harima S, Hashimoto S, Shibata H, Matsunaga T, Tanabe R, Terai S, et al. Correlations between obesity/metabolic syndrome-related factors and risk of developing colorectal tumors. Hepatogastroenterol. 2013;60:733–7.
30.
Endo Y, Ohta M, Tada K, Saga K, Takayama H, Hirashita T, et al. Clinical significance of upper gastrointestinal endoscopy before laparoscopic bariatric procedures in Japanese patients. Surg Today. 2019;49:27–31.CrossRefPubMed
31.
Adams TD, Stroup AM, Gress RE, Adams KF, Calle EE, Smith SC, et al. Cancer incidence and mortality after gastric bypass surgery. Obesity (Silver Spring). 2009;17:796–802.CrossRefPubMed
32.
Janik MR, Clapp B, Sroczynski P, Ghanem O. The effect of bariatric surgery on reducing the risk of colorectal cancer: a meta-analysis of 3,233,044 patients. Surg Obes Relat Dis. 2022.
33.
Kedrin D, Gandhi SCC, Wolf M, Roper J, Yilmaz O, Corey K, et al. Bariatric surgery prior to index screening colonoscopy is associated with a decreased rate of colorectal adenomas in obese individuals. Clin Transl Gastroenterol. 2017;8: e73.CrossRefPubMedPubMedCentral
34.
Droney AC, Sellers W, Gupta A, Johnson KR, Fluck M, Petrick A, et al. Incidence of polyp formation following bariatric surgery. Surg Obes Relat Dis. 2021;17:1773–9.CrossRefPubMed
35.
Hussan H, Drosdak A, Le Roux M, Patel K, Porter K, Clinton SK, et al. The long-term impact of Roux-en-Y gastric bypass on colorectal polyp formation and relation to weight loss outcomes. Obes Surg. 2020;30:407–15.CrossRefPubMed
36.
Peleg N, Sapoznikov S, Levi Z, Dotan I, Shamah S. Incidence of colorectal adenomas after bariatric surgery: pre-operative super morbid obesity is independently associated with increased risk. Obes Surg. 2021;31:4220–6.CrossRefPubMed
Metadata
Title
Clinical significance of colonoscopy before laparoscopic bariatric/metabolic surgery in Japanese patients
Authors
Masayuki Ohta
Yuichi Endo
Hidefumi Shiroshita
Takahide Kawasaki
Takashi Masuda
Teijiro Hirashita
Kensuke Fukuda
Ryo Ogawa
Kazuhiro Mizukami
Takayuki Masaki
Kazunari Murakami
Masafumi Inomata
Publication date
07-06-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 1/2024
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02706-9

Other articles of this Issue 1/2024

Surgery Today 1/2024 Go to the issue

Original Article

Oncoplastic breast surgery to prevent “Bird’s beak” deformity in the breast: a comparative retrospective study

Original Article

The usefulness of chest drain and epicardial pacing wire culture for diagnosing mediastinitis after open-heart surgery

Acknowledgment

Acknowledgment to reviewers

Short Communication

Impact of the coronavirus disease 2019 pandemic on gastric and colorectal cancer surgeries: a multicenter epidemiologic study from the Kinki region of Japan

Review Article

Endogenous and exogenous protection from surgically induced reactive oxygen and nitrogen species

Original Article

The impact of staple transection of the dorsal venous complex and urethra on intraoperative blood loss in cooperative laparoscopic and transperineal endoscopic pelvic exenteration