Detection of Asymptomatic Adenocarcinoma at Endoscopy Prior to Gastric Banding Justifies Routine Endoscopy

Abstract

The detection of two early, asymptomatic oesophageal adenocarcinomas in a high risk patient group justifies our policy of routine upper GI endoscopy prior to gastric banding surgery.

Laparoscopic transhiatal esophagectomy for esophageal adenocarcinoma identified at laparoscopic Roux-en-Y gastric bypass

“…In their series one patient underwent minimally invasive esophagectomy (the technique is not further described) for a pT1N0M0 lesion; one patient who was not fit for esophagectomy had endoscopic mucosal resection (EMR) followed by gastric band placement. Despite the detection of these two cases of malignancy the authors concede that pathology identified at routine pre-operative endoscopy did not significantly alter planned patient management [17] .…”

“…There is controversy regarding the role of pre-operative upper endoscopy in patients undergoing bariatric surgery [17] , [18] . Some authors advocate that all patients with upper gastrointestinal symptoms have upper endoscopy prior to undergoing bariatric surgery [17] .…”

“…There is controversy regarding the role of pre-operative upper endoscopy in patients undergoing bariatric surgery [17] , [18] . Some authors advocate that all patients with upper gastrointestinal symptoms have upper endoscopy prior to undergoing bariatric surgery [17] . The rationale for this routine practice is that pathology may be identified which should be treated prior to surgery or may alter the planned procedure [18] .…”

“…The rationale for this routine practice is that pathology may be identified which should be treated prior to surgery or may alter the planned procedure [18] . Humphreys et al report a series of 371 patients who underwent routine pre-operative upper endoscopy prior to gastric band placement [17] . Two cases of esophageal adenocarcinoma were identified and confirmed.…”

Gastric Carcinoid and Obesity: Association or Coincidence? Report of Two Cases and Literature Review

“…Incidental pathological findings during prebariatric surgery evaluation are many and variable including epithelial and stromal tumors, peptic ulcers, and inflammatory conditions. Humphreys et al reported abnormalities by prebariatric UGIE in 56% of their series of patients, two of them were esophageal adenocarcinoma [2]. Muñoz and his colleagues [3] were able to demonstrate different abnormalities in their 626 series of patients including duodenal and gastric ulcers, polyps, Barrette's esophagus, and gastric cancer.…”