The First Case Report of a Carcinoma of the Gastric Cardia (AEG II) After OAGB-MGB

Runkel, Mira; Pauthner, Michael; Runkel, N.

doi:10.1007/s11695-019-04193-9

Cited by 26 publications

(13 citation statements)

References 9 publications

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“…A physiological hypothesis for these phenomena is that BA reflux could be responsible for chronic inflammation and oxidative stress -two major factors in the initiation of esophageal intestinal metaplasia and the eventual progression to adenocarcinoma 18,19 . Accordingly the first two cases of adenocarcinoma of the esophagogastric junction (AEG) following OAGB have been recently reported; the first reported a carcinoma of the gastric cardia (AEG II) 20 and the second reported an adenocarcinoma of the esophagus (AEG I) 21 . However, it is important to note that in both cases patients were suffering from chronic reflux before and after the surgery.…”

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confidence: 99%

“…However, three of these cancers were located in the region of the stomach excluded from the alimentary tract and only one of these cancers was located in the gastric pouch 10 . As of yet, only two published cases of esophageal or gastric cancer in patients post-OAGB have been published 20,21 but there are no published long-term endoscopic studies. We previously explored the middle-term consequences of OAGB-induced biliary reflux on rats after 16 weeks and did not report an increased risk for esogastric cancer 30 .…”

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confidence: 99%

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Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model

Siebert¹,

Ribeiro-Parenti²,

Nguyen³

et al. 2020

Sci Rep

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Although bariatric surgery is proven to sustain weight loss in morbidly obese patients, long-term adverse effects have yet to be fully characterized. This study compared the long-term consequences of two common forms of bariatric surgery: one-anastomosis gastric bypass (oAGB) and Roux-en-Y Gastric Bypass (RYGB) in a preclinical rat model. We evaluated the influence of biliopancreatic limb (BPL) length, malabsorption, and bile acid (BA) reflux on esogastric mucosa. After 30 weeks of follow-up, Wistar rats operated on RYGB, OAGB with a short BPL (15 cm, OAGB-15), or a long BPL (35 cm, OAGB-35), and unoperated rats exhibit no cases of esogastric cancer, metaplasia, dysplasia, or Barrett's esophagus. Compared to RYGB, OAGB-35 rats presented higher rate of esophagitis, fundic gastritis and perianastomotic foveolar hyperplasia. OAGB-35 rats also revealed the greatest weight loss and malabsorption. on the contrary, BA concentrations were the highest in the residual gastric pouch of OAGB-15 rats. Yet, no association could be established between the esogastric lesions and malabsorption, weight loss, or gastric bile acid concentrations. in conclusion, RYGB results in a better long-term outcome than OAGB, as chronic signs of biliary reflux or reactional gastritis were reported post-oAGB even after reducing the BpL length in a preclinical rat model. Bariatric surgery is widely accepted as a long-term effective treatment for morbid obesity and ensuing metabolic disorders 1. One anastomosis gastric bypass (OAGB) is a promising procedure, first reported in 1997 2. This intervention has been proven safe 2 with some studies even reporting a lower rate of post-operative morbidity compared to the gold standard, Roux-en-Y gastric bypass (RYGB) 3,4. Additionally, OAGB may be preferred to RYGB due to its convenient ability to be reversed 5 and revised 6. Its efficiency in terms of weight loss and control of comorbidities has been widely characterized in the last several decades 7-9 , prompting its potential as an improved alternative to RYGB 7. However, OAGB is still debated due to chronic risks associated with potential biliary reflux 10 on the esogastric tract. OAGB, as all Omega-loop surgical strategies, is characterized by the direct anastomosis of the biliopancreatic loop to the stomach, instead of interposing an alimentary loop as in the Roux-en-Y procedures. This anatomically exposes the esogastric tract to bile acids (BA). In rats, the negative consequences of Omega-loop surgical strategies are well known 11,12. Esojejunal or esoduodenal anastomoses have been reported as experimental models of

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confidence: 99%

mentioning

confidence: 99%

Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model

Siebert¹,

Ribeiro-Parenti²,

Nguyen³

et al. 2020

Sci Rep

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“…Our case was a 52-year-old man who underwent OAGB-MGB (biliopancreatic limb length 200 cm) for super-obesity (BMI 52 kg/m²) in January 2017 (6). Reflux symptoms had pre-existed.…”

Section: Methodsmentioning

confidence: 99%

“…its potential role for promoting esophagogastric cancer. We recently published the first case of a cardia cancer 2 years after OAGB (6). This review explores the risk of cancer development after OAGB.…”

Section: Introductionmentioning

confidence: 99%

Esophago-Gastric Cancer after One Anastomosis Gastric Bypass (OAGB)

Runkel¹,

Runkel²

2019

chr

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Bypass-ul gastric cu o singură anastomoză -one anastomosis gastric bypass (OAGB) este o tehnică bariatrică care presupune creearea unui rezervor gastric tubular anastomozat larg, terminolateral, la jejun. Este o operaţie non-complexă, cu o frecvenţă scăzută a obstrucţiilor intestinale şi o excelentă pierdere în greutate pe termen lung, cu toate acestea, există o teamă de cancerul esofagogastric. Această analiză narativă explorează riscul dezvoltării cancerului după OAGB. Cinci cancere gastrice au fost publicate după minigastric bypass gastric -MGB (o versiune timpurie a OAGB, n = 4) şi după OAGB modern (n = 1), dintre care patru au apărut în stomacul restant şi unul în rezervorul gastric. Refluxul jejuno-gastric este o condiţie normală după OAGB, dar nu există dovezi care să sugereze degenerarea malignă indusă de prezenţa bilei în stomac. Pe de alta parte, deşi refluxul gastro-esofagian este o cauză clară a metaplaziei şi adenocarcinomului esogastric (AEG), totuşi, refluxul gastro-esofagian este rar, şi au fost raportate doar două cazuri de AEG în literatura de specialitate. Evaluarea gastroscopică postoperatorie trebuie luată în considerare la pacienţii cu reflux gastro-esofagian şi / sau hernie hiatală. Când refluxul devine simptomatic, ar trebui recomandată conversia OAGB la bypass gastric pe ansa a la Roux-en-Y.

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“…Moreover, the potential risk of carcinogenesis associated with chronic bile reflux is still under study. Two recent case reports reported the occurrence of cardioesophageal junction (COJ) adenocarcinoma 2 years after OAGB [27,28].…”

Section: Bile Refluxmentioning

confidence: 99%

Conversion of One-Anastomosis Gastric Bypass (OAGB) to Roux-en-Y Gastric Bypass (RYGB) is Effective in Dealing with Late Complications of OAGB: Experience from a Tertiary Bariatric Center and Literature Review

Voon

Huang

Patel

et al. 2021

J Metab Bariatr Surg

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Both primary and revisional bariatric surgery are on the rise due to global obesity pandemic. This study aimed to assess the indications for revision after one-anastomosis gastric bypass (OAGB) and the outcomes after laparoscopic conversion of OAGB to roux-en-y gastric bypass (RYGB). Materials and Methods: Retrospective review on patients that had undergone conversion of OAGB to RYGB between June 2007-June 2019 in a tertiary bariatric center, followed by literature review. Results: Out of 386 revisional bariatric surgery, a total of 14 patients underwent laparoscopic conversion of OAGB to RYGB. The mean age was 44.7 with 71% female. The mean pre-revision BMI was 29.2 kg/m 2 . The primary indications for revision were bile reflux (n=7), marginal ulcer (n=3), inadequate weight loss or weight regain (IWL/WR) (n=3) and protein-calorie malnutrition (n=1). Conversion of OAGB to RYGB was completed laparoscopically in all cases. The mean length of stay was 4.1 days. There was no intraoperative or early post-operative complication. The mean total weight loss (rTWL%) after revision at year one, year three and year five post-revision were 11.5%, 18.1% and 29.1%, respectively. All patients achieved resolution of bile reflux and marginal ulcer. There was no mortality in this cohort. Conclusion: Bile reflux, marginal ulcer, IWL/WR and malnutrition were the main indications for revision after OAGB in this study. In concordance with the available evidence, laparoscopic conversion of OAGB to RYGB was safe and effective in dealing with late complications of OAGB.

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The First Case Report of a Carcinoma of the Gastric Cardia (AEG II) After OAGB-MGB

Cited by 26 publications

References 9 publications

Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model

Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model

Esophago-Gastric Cancer after One Anastomosis Gastric Bypass (OAGB)

Conversion of One-Anastomosis Gastric Bypass (OAGB) to Roux-en-Y Gastric Bypass (RYGB) is Effective in Dealing with Late Complications of OAGB: Experience from a Tertiary Bariatric Center and Literature Review

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