A Case of Gastroesophageal Cancer after Laparoscopic Sleeve Gastrectomy

Abstract

Gastric cancer has been reported in relatively few cases after sleeve gastrectomy, which has become a common bariatric procedure. In this paper, we present a 58-year-old woman diagnosed with gastric cancer by esophagogastroduodenoscopy (EGD) 4 years after sleeve gastrectomy. For that, she underwent distal esophagectomy and total gastrectomy with Roux-en-Y esophagojejunostomy. Preoperative endoscopy is recommended before planning surgery in patients with gastroesophageal reflux symptoms. In addition, annual EGD should be considered after sleeve gastrectomy in patients with risk factors for gastric cancer.

Gastroesophageal Cancer After Laparoscopic Sleeve Gastrectomy

“…This is the second case of gastroesophageal cancer post-sleeve gastrectomy [ 10 ] reported from our institution; however, both patients had their surgery outside our hospital with no preoperative endoscopy as both patients did not report GERD symptoms at that time. In our institution, routine preoperative EGD is performed for all patients regardless of the presence of GERD symptoms to look for evidence of esophagitis, Helicobacter pylori , hiatal hernia, or any other incidental findings.…”

“…Alterations in the levels of adipokines, cytokines, and chemokines, as well as insulin/insulin growth factor pathways, can lead to the progression from inflammation to neoplasia, which is considered another mechanism (GERD-independent mechanism) that can lead to the development of Barrett's esophagus and esophageal adenocarcinoma [9]. This is the second case of gastroesophageal cancer post-sleeve gastrectomy [10] reported from our institution; however, both patients had their surgery outside our hospital with no preoperative endoscopy as both patients did not report GERD symptoms at that time. In our institution, routine preoperative EGD is performed for all patients regardless of the presence of GERD symptoms to look for evidence of esophagitis, Helicobacter pylori, hiatal hernia, or any other incidental findings.…”