Esophagogastric Neoplasms Following Bariatric Surgery: an Updated Systematic Review

Musella, Mario; Berardi, Giovanna; Bocchetti, Alessio; Green, Roberta; Cantoni, Valeria; Velotti, Nunzio; Lauro, Katia Di; Manzolillo, Domenico; Vitiello, Antonio; Milone, Marco; Palma, Giovanni Domenico De

doi:10.1007/s11695-019-03951-z

Cited by 55 publications

(30 citation statements)

References 44 publications

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“…A systematic review by Musella et al has shown that esophageal cancer after primary RYGB and SG is rare (0.02% or 8 out of 42,508 after RYGB and 0.003% or 1 out of 39,137 after SG) [33]. Also, Maret-Ouda et al in a register-based cohort study found no evidence that bariatric surgery (74% of patients had RYGB) may lower the risk of esophageal adenocarcinoma [34].…”

Section: Esophageal/gastric Cancer After Bariatric Surgerymentioning

confidence: 99%

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

et al. 2019

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Background Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett's esophagus (BE) after SG, its treatment has not been studied, yet. Objectives The aim of this study was to evaluate Roux-en-Y gastric bypass (RYGB) as treatment for BE and reflux after SG. Setting University hospital setting, Austria Methods This multi-center study includes all patients (n = 10) that were converted to RYGB due to BE after SG in Austria. The mean interval between SG and RYGB was 42.7 months. The follow-up after RYGB in this study was 33.4 months. Gastroscopy, 24 h pH-metry, and manometry were performed and patients were asked to complete the BAROS and GIQLI questionnaires. Results Weight and BMI at the time of SG was 120.8 kg and 45.1 kg/m 2. Eight patients (80.0%) went into remission of BE after the conversion to RYGB. Two patients had RYGB combined with hiatoplasty. The mean acid exposure time in 24 h decreased from 36.8 to 3.8% and the mean DeMeester score from 110.0 to 16.3. Patients scored 5.1 on average in the BAROS after conversion from SG to RYGB which denotes a very good outcome. Conclusions RYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.

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Section: Esophageal/gastric Cancer After Bariatric Surgerymentioning

confidence: 99%

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

et al. 2019

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“…Patients typically lose 30%-40% body weight in the first year after surgery -a total that is sustained for up to 12 years (13) -and also experience marked improvements in glucose and lipid metabolism (14). However, RYGB is not without its drawbacks, which include severe hypoglycemia (15), malnutrition (16), an increased risk of bone fractures (17), and -in some cases -esophagogastric There is increased interest in whether bariatric surgeries such as Roux-en-Y gastric bypass (RYGB) achieve their profound weight-lowering effects in morbidly obese individuals through the brain. Hypothalamic inflammation is a well-recognized etiologic factor in obesity pathogenesis and so represents a potential target of RYGB, but clinical evidence in support of this is limited.…”

Section: Introductionmentioning

confidence: 99%

Roux-en-Y gastric bypass surgery progressively alters radiologic measures of hypothalamic inflammation in obese patients

Hankir¹,

Rullmann²,

Seyfried³

et al. 2019

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“…Barrett's esophagus is indeed a precancerous lesion and some authors have suggested that this histological alteration might evolve to dysplasia even more rapidly after this operation (66,67). Esophageal adenocarcinoma is in actual fact the most common malignancy emerging after SG and postoperative endoscopic surveillance is fundamental for early diagnosis in this group of patients (69,70,77).…”

Section: Does Gerd Contraindicate Specific Bariatric Procedures?mentioning

confidence: 99%

Obesity Surgery and Cancer: What Are the Unanswered Questions?

et al. 2020

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Obesity has become a global epidemic with a soaring economic encumbrance due to its related morbidity and mortality. Amongst obesity-related conditions, cancer is indeed the most redoubtable. Bariatric surgery has been proven to be the most effective treatment for obesity and its associated metabolic and cardiovascular disorders. However, the understanding of whether and how bariatric surgery determines a reduction in cancer risk is limited. Obesity-related malignancies primarily include colorectal and hormone-sensitive (endometrium, breast, prostate) cancers. Additionally, esophago-gastric tumors are growing to be recognized as a new category mainly associated with post-bariatric surgery outcomes. In fact, certain types of surgical procedures have been described to induce the development and subsequent progression of pre-cancerous esophageal and gastric lesions. This emerging category is of great concern and further research is required to possibly prevent such risks. Published data has generated conflicting results. In fact, while overall cancer risk reduction was reported particularly in women, some authors showed no improvement or even increased cancer incidence. Although various studies have reported beneficial effects of surgery on risk of specific cancer development, fundamental insights into the pathogenesis of obesity-related cancer are indispensable to fully elucidate its mechanisms.

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Esophagogastric Neoplasms Following Bariatric Surgery: an Updated Systematic Review

Cited by 55 publications

References 44 publications

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

Roux-en-Y gastric bypass surgery progressively alters radiologic measures of hypothalamic inflammation in obese patients

Obesity Surgery and Cancer: What Are the Unanswered Questions?

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