Impact of bariatric surgery on surveillance and treatment outcomes of Barrett’s esophagus: A stage-matched cohort study

Esophagectomy for Barrett's adenocarcinoma after multiple bariatric surgeries: A case report

“…Endoscopic resection should be applied whenever possible as surgical resection and reconstruction gets increasingly challenging with the number of bariatric procedures performed on the same patient, with increasing morbidity and mortality rates [1] , [2] , [9] , [18] . It is therefore of paramount importance to screen any precancerous lesion prior to any bariatric surgery [1] , [3] , [4] , [7] , [8] and to assess any new onset of symptoms occurring after a weight loss procedure [1] , [2] , [3] , [4] , [6] , [7] , [8] , [11] , [12] with endoscopic evaluation.…”

“…Endoscopic procedures such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are the treatment of choice for early stages of ADK [2] , [9] , [11] , [12] , [13] , [14] . But surgery may become compulsory in case of positive margins on the resection specimen without possibility of further endoscopic resection [7] , [13] , [14] , in case of submucosal infiltration by the tumor (T1b) due to the higher risk of lymph node involvement [7] , [13] , [14] , [15] , in case of vascular or lymphatic emboli [7] , [13] , [14] , in more aggressive tumors [13] , [14] or advanced cases.…”

“…It has also been shown that bariatric surgery reduces cancer incidence by multiple aspects such as diminishing the body mass index [2] , [4] , [6] , [8] , [9] . Nevertheless, there are cases of neoplasms developed after a bariatric procedure either due to the natural history of the cancer or to anatomical and physiological changes due do the bariatric surgery itself [1] , [6] , [10] , [11] , [12] .…”

“…By worsening a gastroesophageal reflux, restrictive procedures such as laparoscopic adjustable gastric banding (LAGB) or sleeve gastrectomy (SG) can create or exacerbate a BE [2] , [7] , [8] , [10] , which can evolve more rapidly to dysplasia leading to an esophageal adenocarcinoma (ADK) [8] , [10] . Even though the Roux-en-Y gastric bypass (RYGB) is considered as the best anti-reflux procedure and may sometimes cure a BE [1] , [4] , [7] , [8] , [10] , [11] , [12] , there is still a risk to develop a high grade dysplasia (HGD) or an adenocarcinoma [11] , [12] .…”

Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population

“…As discussed above, some studies have proposed endoscopic surveillance post-bariatric surgery to assess disease progression to Barrett's esophagus and esophageal adenocarcinoma [147][148][149]. Endoscopy prior to bariatric surgery and obtaining a thorough history regarding gastroesophageal reflux symptoms may improve patient selection for bariatric surgery [135].…”