학술논문
Treatment of esophageal adenocarcinoma in patients with a history of bariatric surgery.
Document Type
Academic Journal
Author
Nobel T; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Sewell M; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Boerner T; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Bains MS; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Bott MJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Gerdes H; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Gray K; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Nishimura M; Gastroenterology, Hepatology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Park BJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Shah P; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Sihag S; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Jones DR; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Molena D; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States. Electronic address: molenad@mskcc.org.
Source
Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9706084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4626 (Electronic) Linking ISSN: 1091255X NLM ISO Abbreviation: J Gastrointest Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The relationship among obesity, bariatric surgery, and esophageal adenocarcinoma (EAC) is complex, given that some bariatric procedures are thought to be associated with increased incidence of reflux and Barrett's esophagus. Previous bariatric surgery may complicate the use of the stomach as a conduit for esophagectomy. In this study, we presented our experience with patients who developed EAC after bariatric surgery and described the challenges encountered and the techniques used.
Methods: We conducted a retrospective review of our institutional database to identify all patients at our institution who were treated for EAC after previously undergoing bariatric surgery.
Results: In total, 19 patients underwent resection with curative intent for EAC after bariatric surgery, including 10 patients who underwent sleeve gastrectomy. The median age at diagnosis of EAC was 63 years; patients who underwent sleeve gastrectomy were younger (median age, 56 years). The median time from bariatric surgery to EAC was 7 years. Most patients had a body mass index (BMI) score of >30 kg/m2 at the time of diagnosis of EAC; approximately 40% had class III obesity (BMI score > 40 kg/m 2 ). Six patients (32%) had known Barrett's esophagus before undergoing a reflux-increasing bariatric procedure. Sleeve gastrectomy patients underwent esophagectomy with gastric conduit, colonic interposition, or esophagojejunostomy. Only 1 patient had an anastomotic leak (after esophagojejunostomy).
Conclusion: Endoscopy should be required both before (for treatment selection) and after all bariatric surgical procedures. Resection of EAC after bariatric surgery requires a highly individualized approach but is safe and feasible.
(Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.)
Methods: We conducted a retrospective review of our institutional database to identify all patients at our institution who were treated for EAC after previously undergoing bariatric surgery.
Results: In total, 19 patients underwent resection with curative intent for EAC after bariatric surgery, including 10 patients who underwent sleeve gastrectomy. The median age at diagnosis of EAC was 63 years; patients who underwent sleeve gastrectomy were younger (median age, 56 years). The median time from bariatric surgery to EAC was 7 years. Most patients had a body mass index (BMI) score of >30 kg/m
Conclusion: Endoscopy should be required both before (for treatment selection) and after all bariatric surgical procedures. Resection of EAC after bariatric surgery requires a highly individualized approach but is safe and feasible.
(Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.)