Adenocarcinoma of the gastroesophageal junction after bariatric surgery

Abstract Background The development of upper gastrointestinal malignancies after bariatric surgery has not been well characterized. Our objective was to review the experience of patients with distal esophageal cancer that was diagnosed after bariatric surgery. Methods A retrospective review was cond...

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Bibliographic Details
Published in:The American journal of surgery 2008-07, Vol.196 (1), p.135-138
Main Authors: Melstrom, Laleh G., M.D., M.S.C.I, Bentrem, David J., M.D, Salvino, Michael J., M.D, Blum, Matthew G., M.D, Talamonti, Mark S., M.D, Printen, Kenneth J., M.D
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - etiology
Aged
Bariatric Surgery
Barrett Esophagus - etiology
Biological and medical sciences
Body mass index
Diet
Dysphagia
Esophageal cancer
Esophageal Neoplasms - etiology
Esophagogastric Junction
Esophagus
Gastroenterology. Liver. Pancreas. Abdomen
Gastroesophageal junction
Gastroesophageal Reflux - etiology
Gastrointestinal surgery
General aspects
Humans
Male
Medical sciences
Middle Aged
Obesity
Obesity, Morbid - complications
Obesity, Morbid - surgery
Ostomy
Pathology
Patients
Postoperative Complications
Retrospective Studies
Surgery
Tomography
Tumors
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Summary:Abstract Background The development of upper gastrointestinal malignancies after bariatric surgery has not been well characterized. Our objective was to review the experience of patients with distal esophageal cancer that was diagnosed after bariatric surgery. Methods A retrospective review was conducted to identify patients who had undergone bariatric surgery (1999 to 2006) and who later developed high-grade dysplasia or adenocarcinoma of the distal esophagus. Results Three patients (of 2,875 [0.1%]) developed esophageal cancer: 2 after Roux-en-Y gastric bypass and 1 after vertical banded gastroplasty. All three patients had complaints of reflux, and two were treated with esophagectomy. The third patient presented with invasive carcinoma and died 2 years after diagnosis. Conclusions Our findings emphasize the importance of precise endoscopic evaluation before bariatric surgery in patients with gastroesophageal reflux disease (GERD), of the necessity for continuing postsurgical surveillance in patients with known Barrett's esophagitis, and of early evaluation in patients who develop new symptoms of GERD after bariatric surgery.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.07.026