Gastric Cancer after Roux-en-Y Gastric Bypass

Abstract

Roux-en-Y gastric bypass (RYGBP) is one of the most commonly performed surgical procedures for morbid obesity. Several complications that may develop in the short- and long-term have been reported. We present a patient who presented with cancer in the bypassed stomach 8 years after RYGBP. Although the development of this lesion is rare and only a few cases have been reported, there are aspects worthy of discussion. Several monitoring, diagnostic and therapeutic alternatives are analyzed.

Risk of Gastric Cancer After Roux-en-Y Gastric Bypass

“…Although this is a nonphysiologic condition, large series of RYGB showed low morbidity in the excluded part of the stomach. 4 In the literature, only a few reports [5][6][7][8] have documented cancer in the excluded part of the stomach after RYGB. However, the stomach is an organ that is prone to cancer development, and gastric cancer is the second cause of cancer death in the world, causing 734 000 deaths annually.…”

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

“…4 Five cases of adenocarcinoma of the distal stomach have been reported after gastric bypass. [18][19][20][21][22] Cancer was diagnosed at an advanced stage in four of the cases, 4,5, 8 and 22 years after the procedure. The patient with the carcinoma in the bypassed stomach at 4 years had had intestinal metaplasia and HP (given eradication therapy) on endoscopy before the RYGBP.…”

Report of Two Cases of Gastric Cancer after Bariatric Surgery: Lymphoma of the Bypassed Stomach after Roux-en-Y Gastric Bypass and Gastrointestinal Stromal Tumor (GIST) after Vertical Banded Gastroplasty

“…Four cases of adenocarcinoma of the distal stomach have been reported after gastric bypass. [16][17][18][19] Cancer was diagnosed at an advanced stage in 3 of the cases at 5, 8 and 22 years after the gastric bypass, when symptoms were now secondary to occlusion of the pylorus by the tumor. A fourth patient presented with anemia that was investigated for a year before an endoscopy evaluated the distal stomach through the loop gastroentrostomy and diagnosed two polypoid early gastric cancers.…”