Value of Preoperative Upper Endoscopy in Patients Undergoing Laparoscopic Gastric Bypass

Zeni, Tallal M.; Frantzides, Constantine T.; Mahr, Claudius; Denham, Ervin W.; Meiselman, Mick; Goldberg, Michael J.; Spiess, Susannah E.; Brand, Randall E.

doi:10.1381/096089206775565177

Cited by 109 publications

(67 citation statements)

References 20 publications

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“…[51][52][53] The importance of preoperative endoscopy is supported by Sharaf et al 54 who found that 90% of their 195 patients had one or more lesions, with 60% that changed or delayed the clinical approach, including 3% Barrett's esophagus. Similarly, preoperative endoscopic findings reported by Zeni et al 55 from 169 patients, included in addition to two cases of Barrett's esophagus, one case of GIST and one case of gastric polyp that both necessitated a partial gastrectomy. The yield is higher if the endoscopy is symptom-oriented.…”

Section: Discussionmentioning

confidence: 70%

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

Roover¹,

Detry²,

Desaive³

et al. 2006

obes surg

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The authors discuss the potential influence of obesity surgery on the risk of cancer, focusing on the upper Gl tract directly affected by operations. There is currently no substantiation for an increased risk of cancer after bariatric surgery, because there are only about 25 reports of subsequent cancer of the esophagus and the stomach. However, this review emphasizes the need to detect potential precancerous conditions before surgery. Candidates for postoperative endoscopic surveillance may include patients >15 years after gastric surgery, but also patients symptomatic for gastroesophageal reflux disease in whom a high incidence of Barrett's metaplasia has been reported. The greatest concern is a delay in diagnosis from inadequate investigation due to mistaking serious upper Gl symptoms as a consequence of the past operation.

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Section: Discussionmentioning

confidence: 70%

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

Roover¹,

Detry²,

Desaive³

et al. 2006

obes surg

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show abstract

“…Other authors have reported the presence of gastric 15 and duodenal 16 NET in the preoperative setting. In fact, upper gastrointestinal endoscopy is recommended in the pre-bariatric surgery evaluation, 17 rendering possible the NET diagnosis before the surgical procedure. Al-Harbi et al 18 believe that gastric NETs are probably related to abnormal feeding behavior of the obese patients.…”

Section: Echocardiogrammentioning

confidence: 99%

Carcinoid Syndrome and Carcinoid Heart Disease as Manifestations of Non-Metastatic Ovarian Neuroendocrine Tumour

et al. 2017

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The carcinoid syndrome is rare but it is associated with carcinoid heart disease in more than a half of the cases. Carcinoid heart disease is typically characterised by morphological and functional modifications of right-sided valves. Its aetiology is probable multifactorial but serotonin appears to play a key role in the development of this valvular disease. Unlike gastrointestinal neuroendocrine tumours, ovarian neuroendocrine tumours can present with carcinoid syndrome and carcinoid heart disease in the absence of liver metastases; such ovarian neuroendocrine tumours are a unique clinical entity. The additional burden of cardiac impairment in these patients represents a significant reduction in survival. Early recognition and surgical valve replacement before advanced heart failure is established may improve the clinical outcome. We report the case of a woman with an ovarian neuroendocrine tumour and highly symptomatic carcinoid heart disease who was submitted to tumour resection followed by valvuloplasty. She demonstrated an outstanding clinical improvement and has remained free of tumour and symptomatology. Keywords: Carcinoma, Neuroendocrine; Carcinoid Heart Disease; Carcinoid Tumor; Ovarian Neoplasms RESUMOA síndrome carcinoide é rara mas encontra-se associada, em cerca de metade dos casos, a doença carcinoide cardíaca. Esta patologia cardíaca caracteriza-se tipicamente por alterações morfo-funcionais das válvulas direitas. A sua etiologia é provavelmente multifatorial mas, aparentemente, a serotonina parece exercer um papel preponderante no desenvolvimento desta doença valvular. Ao contrário dos tumores neuroendócrinos gastrointestinais, os tumores neuroendócrinos do ovário podem apresentar síndrome carcinoide e doença carcinoide cardíaca na ausência de metastização hepática, tornando os tumores neuroendócrinos do ovário uma entidade clínica única. Estas alterações cardíacas acarretam uma diminuição adicional da sobrevivência destes doentes. Portanto, o reconhecimento precoce desta entidade e a substituição valvular prévia ao estabelecimento da insuficiência cardíaca avançada podem melhorar a evolução clínica destes doentes. Os autores apresentam o caso de uma mulher com tumor neuroendócrino do ovário e doença carcinoide cardíaca muito sintomática que foi submetida a resseção tumoral seguida de valvuloplastia. A doente demonstrou uma marcada melhoria clínica e tem permanecido livre de doença e assintomática.

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“…En el contorno superior de ambos fragmentos, la flecha señala la unión gastro-esofágica. Palmer 8 en una revisión clásica, de 1.660 casos publicados, de tumores intramurales gástricos, los clasifica en: Leiomoma (37 a 56%), fibroma (17 a 30%), neurogénicos, (schwannomas o neurinemomas y neurofibromas) (5 a 16%), páncreas aberrante (5 a 13%), lipomas (2 a 6%), tumores de origen vascular (1 a 6%) y tumores quísticos (1 a 5%).…”

Section: Caso Clínicounclassified

“…La presencia de TIMG, son un hecho bien documentado 2,3,8,9 , si bien su incidencia global no supera el 1% de los pacientes sometidos a cirugía bariátrica y, siendo la mayoría de los casos hallazgos intraoperatorios, se recomienda efectuar una cuidadosa revisión gástrica durante la cirugía 3 , antes de confeccionar el reservorio gástrico. Zeni 2 , enfatiza el rol de la endoscopía de EED, como parte del estudio preoperatorio en estos pacientes.…”

Section: Caso Clínicounclassified

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Obesidad mórbida asociada a quiste broncogénico y leiomioma subcardial que simula GIST: Caso clínico

et al. 2009

Rev Chil Cir

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Morbid obesity, esophageal bronchogenic cyst and subcardial leiomioma. Report of one caseGastric wall diseases are found in approximately of 1% of the patients submitted to bariatric surgery. Half of these are leiomiomas. Esophageal bronchogenic cysts are exceptional We report a 57 years old female with morbid obesity, a bronchogenic esophageal cyst and subcardial leiomioma. The preoperative study and intraoperative biopsy, suggested the presence of a gastrointestinal stromal tumor (GIST), but the definitive pathological study did not confirm its presence. A total gastrectomy was performed, with an uneventful postoperative course.Key words: GIST, morbid obesity, bronchogenic esophageal cyst, leiomioma, total gastrectomy. ResumenLa patología intramural gástrica tiene una frecuencia menor al 1%, en cirugía gástrica. Alrededor del 50% corresponden a leiomiomas. Los quistes broncogénicos tienen origen embriológico y son excepcionales, y la mayor parte de los reportes corresponden a pacientes pediátricos. Se presenta un caso clínico de paciente portadora de Obesidad mórbida (IMC = 52), asociado a lesión subcardial que simula GIST, cuyo estudio histopatológico resultó ser un quiste esofágico de origen broncogénico de 40 mm, asociado a leiomioma subcardial de 10 mm. Fue sometida a gastrectomía total más anastomosis esófago-yeyunal en Y de Roux, con asa de 180 cm. No presentó morbi-mortalidad postoperatoria. Se discuten los métodos de estudio preoperatorio y las alternativas terapéuticas. No hemos encontrado en la literatura otro caso de asociación de estas raras patologías.Palabras clave: GIST, obesidad mórbida, quiste broncogénico esofágico, leiomioma, gastrectomía total.

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Value of Preoperative Upper Endoscopy in Patients Undergoing Laparoscopic Gastric Bypass

Abstract: EGD is essential for diagnosis of GI diseases including tumors, ulcers, and hiatal hernias that alter the medical and surgical management of patients undergoing gastric bypass.

Cited by 109 publications

References 20 publications

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

Carcinoid Syndrome and Carcinoid Heart Disease as Manifestations of Non-Metastatic Ovarian Neuroendocrine Tumour

Obesidad mórbida asociada a quiste broncogénico y leiomioma subcardial que simula GIST: Caso clínico

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