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Kanno M, Umemura A, Baba S, Nikai H, Sugimoto R, Sasaki A. Gastric cancer after laparoscopic adjustable gastric banding: A case report. Int J Surg Case Rep 2024; 119:109714. [PMID: 38678993 PMCID: PMC11063896 DOI: 10.1016/j.ijscr.2024.109714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024] Open
Abstract
INTRODUCTION Gastric cancer occurring after bariatric and metabolic surgeries is rare. We report a case of gastric cancer that developed at 14 years after laparoscopic adjustable gastric banding. PRESENTATION OF CASE The patient was an obese 81-year-old woman who underwent LAGB at 14 years prior when her body mass index was 35.3 kg/m2. Anemia was noted during a visit to her family clinic. Subsequent esophagogastroduodenoscopy revealed a type 5 lesion (Macroscopic Classification of the Gastric Cancer in Japanese Classification of Gastric Carcinoma, The 15th Edition) near the greater curvature of the posterior wall of the gastric antrum. A biopsy indicated a poorly differentiated adenocarcinoma. Computed tomography showed no evidence of invasion of other organs, lymph node metastasis, or distant metastasis. The patient underwent laparoscopy-assisted distal gastrectomy, banding removal, Roux-en-Y reconstruction. The histopathological diagnosis was pT3N2M0 and pStage IIIA. The patient exhibited an uneventful postoperative course and was discharged on postoperative day 8. The patient has remained recurrence-free up to 12 months postoperatively. DISCUSSION While metabolic surgeries have been shown to reduce the risk of developing malignant diseases, including gastric cancer, the present patient developed gastric cancer at 14 years after laparoscopic adjustable gastric banding. The patient developed gastric cancer during a long-term course, indicating the importance of periodic examinations after metabolic surgery. CONCLUSIONS Previous studies showed metabolic surgeries for obesity reduce the risk of developing malignancies, including gastric cancer; however, the present case suggests that gastric cancer may develop over a long-term course.
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Affiliation(s)
- Masaki Kanno
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
| | - Akira Umemura
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
| | - Shigeaki Baba
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
| | - Haruka Nikai
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
| | - Ryo Sugimoto
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
| | - Akira Sasaki
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan.
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Chen ZW, Jin T, Liang PP, Li ZD, He FJ, Chen ZH, Song XH, Zhu YF, Hu JK, Yang K. Incidence of cancer for patients after bariatric surgery: evidence from 33 cohort studies. Surg Obes Relat Dis 2024; 20:467-481. [PMID: 38151417 DOI: 10.1016/j.soard.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 10/30/2023] [Accepted: 11/18/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND With the rising prevalence of severe obesity, bariatric surgery has emerged as a crucial treatment option. As the number of surgeries performed worldwide increases, there has been growing interest in the impact of bariatric surgery on cancer incidence. While several studies have examined this relationship, the topic remains controversial. OBJECTIVES We conducted this systematic review of cohort studies with meta-analysis to evaluate the effect of bariatric surgery versus nonsurgical treatment on overall cancer incidence. However, the effects may vary when focusing on specific cancer types, surgical procedures, or gender, so we conducted additional subgroup analyses. SETTING A meta-analysis. University hospital. METHODS The Cochrane, Embase, PubMed, and Web of Science databases were searched for studies from 1 January 2000 to 1 December 2022. Meta-analysis was conducted to evaluate the pooled effect and further implemented subgroup analysis stratified by cancer type, operation type, and sex. RESULTS All cohort studies were included in this meta-analysis from 18,216 studies. The overall cancer incidence demonstrated a significant decrease in the group with bariatric surgery (odds ratios [OR] = .56, P = .000, 95% CI .46 to .68). In subgroup analysis, similar decrease effect was found in 9 cancers. Furthermore, the incidence of cancer decreased significantly in male (OR = .66, P = .001, 95% CI .51 to .85) and female patients (OR = .63, P = .000, 95% CI .57 to .69) and patients undergoing gastric bypass (OR = .46, P = .000, 95% CI .33 to .63) or sleeve gastrectomy (OR = .44, P = .001, 95% CI .27 to .70). CONCLUSIONS In the overall analysis, bariatric surgery could reduce the incidence of cancer significantly. Further large-scale well-matched studies are needed to verify the protective effect of bariatric surgery on cancer incidence.
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Affiliation(s)
- Zheng-Wen Chen
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Tao Jin
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Pan-Ping Liang
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ze-Dong Li
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Feng-Jun He
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ze-Hua Chen
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiao-Hai Song
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yun-Feng Zhu
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jian-Kun Hu
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Kun Yang
- Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Parmar C, Pouwels S. Oesophageal and Gastric Cancer After Bariatric Surgery: an Up-to-Date Systematic Scoping Review of Literature of 324 Cases. Obes Surg 2022; 32:3854-3862. [PMID: 36241765 DOI: 10.1007/s11695-022-06304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND This review aimed to give an updated overview of the occurrence, diagnosis, treatment and outcome of oesophageal and gastric cancer after bariatric and metabolic surgery (BMS). METHODS Two searches were done (one for original studies and one for systematic reviews) using an adapted form of "scoping review methodology". MEDLINE, Embase, CINAHL, Pubmed and the Cochrane Library were searched for studies on patients with either oesophageal or gastric cancer after BMS. RESULTS A total of 52 unique studies were included which reported on 324 patients, which included 110 (34%) males and 136 (42%) females. In the remaining 78 patients, gender was not specified. A mean of 62.95 ± 32.75 months was the time from BMS to diagnosis of cancer. Most of the patients had a Roux-en-Y gastric bypass (RYGB) as index bariatric surgical procedure, followed by gastric banding (GB) and sleeve gastrectomy (SG) (respectively, 133 (41.0%) RYGB, 97 (30.0%) GB and 58 (18.0%) SG). Seven cases have been reported after OAGB-MGB (3 in gastric remnant, 4 in oesophagus/gastric pouch). Seventy-seven (24%) had distant metastasis (≥ M1/Mx status). The majority of tumours were adenocarcinoma (n = 208, 87.4%). In the majority of the cases, a surgical approach was preferred with either adjuvant chemo or radiotherapy. In the course of the disease, 122 of 324 patients died (37.8%). CONCLUSION To our knowledge, this is the most up-to-date review addressing oesophageal and gastric malignancies after bariatric surgery. Future research should focus to optimise screening for oesophageal and gastric cancer after bariatric surgery.
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Affiliation(s)
- Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, UK.
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, Netherlands
- Department of Surgery, Agaplesion Bethanien Hospital, Frankfurt am Main, Hessen, Germany
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Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis. Updates Surg 2021; 73:639-647. [PMID: 33606148 DOI: 10.1007/s13304-020-00938-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although different procedures have been proposed as revisional surgery for patients who had previously undergone a failed primary restrictive procedure, the ideal revisional procedure is still a matter of debate. METHODS A systematic search was performed in all electronic databases to find studies comparing one anastomosis-mini gastric bypass (OAGB-MGB) or Roux-en-Y gastric bypass (RYGB) as revisional bariatric surgery for weight regain or intolerance/complications of a primary restrictive procedure. The data regarding sample size, patients' gender, age, primary surgery type, number of perioperative complications, operative time, pre- and post-revisional body mass index (BMI), and excess weight loss % (EWL%) at 1-year follow-up were extracted. Five studies were included in the analysis. RESULTS The primary bariatric procedures were represented by vertical banded gastroplasty (VBG), laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG). About perioperative complications, both RYGB and OAGB-MGB showed a similar rate of leaks but OAGB-MGB had a lower rate of bleedings; considering the progression from pre- to post-revisional BMI, OAGB-MGB reveals a better outcome as well as a shorter operative time. CONCLUSIONS Our meta-analysis has shown OAGB-MGB, used as revisional intervention after failed restrictive surgery, achieves outcomes comparable to RYGB in terms of perioperative complications providing a simpler and more effective technique.
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