Esophagogastric cancer after bariatric surgery: systematic review of the literature

Scozzari, Gitana; Trapani, Renza; Toppino, M; Morino, Mario

doi:10.1016/j.soard.2012.10.002

Cited by 125 publications

(86 citation statements)

References 73 publications

(134 reference statements)

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“…When present, significant reflux will usually affect the surgeon's procedure recommendation as reflux symptoms significantly improve after RYGB, whereas the effects of LSG and LAGB on reflux are not conclusively understood (118,119,120). There is no evidence of a greater risk of dysplasia or neoplasia of the esophagus after bariatric surgery, and a recent systematic review reported only 11 cases reaching back as far as 1996 (121). Epidemiological data have shown that obesity is associated with an increased risk of esophageal cancer (122), along with cancers of the thyroid, colorectum, breast, endometrium, cervix, ovary, kidney, stomach, liver, gallbladder and pancreas (122, 123).…”

Section: Exceptional Circumstancesmentioning

confidence: 99%

Should bariatric surgery be performed in adolescents?

Beamish

Reinehr

2017

European Journal of Endocrinology

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Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.

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Section: Exceptional Circumstancesmentioning

confidence: 99%

Should bariatric surgery be performed in adolescents?

Beamish

Reinehr

2017

European Journal of Endocrinology

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“…Obesity is the driving force behind the metabolic syndrome, characterized by (central) obesity, insulin resistance, dyslipidemia, and hypertension [1,[4][5][6]. This condition, also known as the "deadly quartet," increases the risk of developing diabetes mellitus and cardiovascular diseases, but also has a (systemic) carcinogenic effect resulting in an increased risk of developing various types of cancer, with esophageal adenocarcinoma leading this list [3,5,6]. It has been shown that following BS, the risk of developing a variety of different tumors decreases again, further indicating that this relationship between obesity and carcinogenesis is indeed causal [4].…”

Section: Obesity and Its Carcinogenic Potentialmentioning

confidence: 99%

“…Vague symptoms, such as mild dysphagia and abdominal pain, are the first and often only signs [3]. Particular diagnostic challenge occurs when a malignancy develops in the excluded gastric remnant following gastric bypass surgery.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

“…Also, a potentially curative resection is often more complex and reconstruction of the gastrointestinal continuity can be seriously hampered. Conclusion: Due to the growing incidence of obesity and the increasing number of bariatric surgical procedures that are performed each year, it is expected that over the years to come, more post-BS patients will be diagnosed with upper countered bile duct stones, an endoscopic retrograde cholangiopancreatography becomes challenging [3]. Finally, a less frequent, but particularly difficult problem arises when an upper gastrointestinal malignancy develops in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Challenges in Upper Gastrointestinal Malignancies after Bariatric Surgery

Tse

Kroon

Lanschot³

2017

Dig Surg

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Background/Aims: The incidence of morbid obesity has exponentially increased over the last decades. Bariatric surgery (BS) has been proven effective in inducing weight loss and resolving comorbidities associated with morbid obesity. However, BS can also lead to major diagnostic and treatment challenges in patients who develop upper gastrointestinal malignancies. It is important to create awareness of this rising problem. Methods: Relevant literature was searched in PubMed. Results: (Formerly) obese patients are more prone to develop upper gastrointestinal malignancies, mainly adenocarcinoma of the distal esophagus, since obesity induces a chronic pro-inflammatory state due to endocrinological changes. When an upper gastrointestinal malignancy develops after BS, diagnosis is often delayed and challenging due to a different presentation of complaints and the altered anatomy following the earlier surgery. Also, a potentially curative resection is often more complex and reconstruction of the gastrointestinal continuity can be seriously hampered. Conclusion: Due to the growing incidence of obesity and the increasing number of bariatric surgical procedures that are performed each year, it is expected that over the years to come, more post-BS patients will be diagnosed with upper gastrointestinal malignancies, providing great diagnostic and treatment challenges. Clinicians should be aware of this rising problem.

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“…After RYGB, lap-band or LSG, carcinoma of the gastric pouch and lower esophagus was reported in 46 patients [40][41][42]. After LSG, Barrett's esophagus may occur [43].…”

Section: Fear Of Development Of Cancermentioning

confidence: 99%