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Diab ARF, Oviedo RJ, Nazir S, Sujka JA, DuCoin CG. Foregut Malignancy After Metabolic Surgery: a Literature Review. Obes Surg 2023; 33:623-634. [PMID: 36538212 DOI: 10.1007/s11695-022-06412-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
Obesity is known to be epidemiologically associated with malignancy. Although there is an increasing global number of bariatric surgeries, the relationship between bariatric surgery and esophagogastric cancers is not well understood. Diagnosis of esophagogastric cancers following bariatric surgery is challenging because the presentation tends to be nonspecific and may be perceived as usual postoperative symptoms in bariatric patients. Therefore, the early diagnosis requires a high index of suspicion. In addition, endoscopic investigation of the excluded stomach after a Roux-en-Y gastric bypass or a one-anastomosis gastric bypass is technically challenging, which further complicates the diagnosis. The aim of this study is to review the current evidence in the literature on esophagogastric cancers following bariatric surgery.
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Affiliation(s)
- Abdul-Rahman F Diab
- Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA.
| | - Rodolfo J Oviedo
- Houston Methodist Department of Surgery, Houston, TX, USA.,Weill Cornell Medical College, New York, NY, USA.,Texas A&M University College of Medicine, Bryan, TX, USA
| | - Sharique Nazir
- Department of Surgery, NYU Grossman School of Medicine, 8714 Fifth Avenue, Brooklyn, NY, 11209, USA
| | - Joseph A Sujka
- Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA
| | - Christopher G DuCoin
- Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA
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Youk KM, Kim J, Cho YS, Park DJ. Gastric Cancer After Bariatric Surgeries. JOURNAL OF METABOLIC AND BARIATRIC SURGERY 2022; 11:20-29. [PMID: 36926673 PMCID: PMC10011677 DOI: 10.17476/jmbs.2022.11.2.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 03/18/2023]
Abstract
Bariatric surgery has been covered by medical insurance in Korea, since January 2019; and its number is steadily increasing. Representative bariatric surgeries include adjustable gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass. Each surgical method can be applied according to the patient's condition; however, there are other issues to consider in Korea. Because of the high incidence of gastric cancer in Korea, gastroscopy is recommended every two years after the age of 40. Therefore, it is difficult to perform conventional gastroscopy after Roux-en-Y gastric bypass. In this review, the incidence of gastric cancer after representative bariatric surgery was investigated through a literature review, so that it could be used as a reference for the selection of bariatric surgery in Korea.
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Affiliation(s)
- Kang Min Youk
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jeesun Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yo-Seok Cho
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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3
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Eagle ZR, Essien F, Zibert K, Miller C, Van Dellen M, Eden R, Pinson R. Helicobacter pylori-negative extra-nodal marginal zone B-cell lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) type following Roux-en-Y Gastric Bypass (RYGB). Clin Case Rep 2022; 10:e05261. [PMID: 35106160 PMCID: PMC8784857 DOI: 10.1002/ccr3.5261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/17/2021] [Accepted: 11/19/2021] [Indexed: 11/07/2022] Open
Abstract
Gastric MALT lymphoma is a common type of non-Hodgkin's lymphoma that has the potential for cure in patients found to have concomitant Helicobacter pylori (H. pylori) infection. This case report explores the evaluation, diagnosis, and treatment of H. pylori-negative MALT lymphoma in a patient with a history of a RYGB.
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Affiliation(s)
- Zachary R. Eagle
- Department of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
| | - Francis Essien
- Department of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
| | - Kimberly Zibert
- Division of GastroenterologyDepartment of Internal MedicineSan Antonio Medical CenterSan AntonioTexasUSA
| | - Charles Miller
- Division of GastroenterologyDepartment of Internal MedicineSan Antonio Medical CenterSan AntonioTexasUSA
| | - Melissa Van Dellen
- Division of PathologyDepartment of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
| | - Rina Eden
- Division of PathologyDepartment of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
| | - Ross Pinson
- Department of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
- Division of GastroenterologyDepartment of Internal MedicineKeesler Medical CenterKeesler Air Force BaseKeesler AFBMississippiUSA
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Ebrahimi R, Kermansaravi M, Khalaj A, Eghbali F, Mousavi A, Pazouki A. Gastro-Intestinal Tract Cancers Following Bariatric Surgery: a Narrative Review. Obes Surg 2020; 29:2678-2694. [PMID: 31175561 DOI: 10.1007/s11695-019-04007-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The association between obesity and malignancies has been identified epidemiologically. Meanwhile, the increasing global number of bariatric surgeries is reported annually; bariatric surgery's effect on different types of cancers is not well understood. Unfortunately, nonspecific presentations and difficulties regarding investigations make diagnosis challenging. The aim of this study is to compile available data about gastro-intestinal (GI) cancers, occurring after different bariatric surgeries. Although GI cancers are considered a rare complication of obesity surgery, they do exist, and diagnosis needs a high index of suspicion.
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Affiliation(s)
- Reza Ebrahimi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kermansaravi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Center of Excellence of International Federation for Surgery of Obesity, Hazrat e Rasool Hospital, Tehran, Iran.
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Foolad Eghbali
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of International Federation for Surgery of Obesity, Hazrat e Rasool Hospital, Tehran, Iran
| | - Ali Mousavi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of International Federation for Surgery of Obesity, Hazrat e Rasool Hospital, Tehran, Iran
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Morano WF, Shaikh MF, Gleeson EM, Galvez A, Khalili M, Lieb J, Renza-Stingone EP, Bowne WB. Reconstruction options following pancreaticoduodenectomy after Roux-en-Y gastric bypass: a systematic review. World J Surg Oncol 2018; 16:168. [PMID: 30103758 PMCID: PMC6090772 DOI: 10.1186/s12957-018-1467-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/03/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Obesity is a risk factor for pancreatic cancer which may be treated with Roux-en-Y gastric bypass and represents an increasing morbidity. Post-RYGB anatomy poses considerable challenges for reconstruction after pancreaticoduodenectomy (PD), a growing problem encountered by surgeons. We characterize specific strategies used for post-PD reconstruction in the RYGB patient. METHODS PubMed search was performed using MeSH terms "Gastric Bypass" and "Pancreaticoduodenectomy" between 2000 and 2018. Articles reporting cases of pancreaticoduodenectomy in post-RYGB patients were included and systematically reviewed for this study. RESULTS Three case reports and five case series (25 patients) addressed PD after RYGB; we report one additional case. The typical post-gastric bypass PD patient is a woman in the sixth decade of life, presenting most commonly with pain (69.2%) and/or jaundice (53.8%), median 5 years after RYGB. Five post-PD reconstructive options are reported. Among these, the gastric remnant was resected in 18 cases (69.2%), with reconstruction of biliopancreatic drainage most commonly achieved using the distal jejunal segment of the pre-existing biliopancreatic limb (73.1%). Similarly, in the eight cases where the gastric remnant was spared (30.8%), drainage was most commonly performed using the distal jejunal segment of the biliopancreatic limb (50%). Among the 17 cases reporting follow-up data, median was 27 months. CONCLUSION Reconstruction options after PD in the post-RYGB patient focus on resection or preservation gastric remnant, as well as creation of new biliopancreatic limb. Insufficient data exists to make recommendations regarding the optimal reconstruction option, yet surgeons must prepare for the possible clinical challenge. PD reconstruction post-RYGB requires evaluation through prospective studies.
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Affiliation(s)
- William F. Morano
- Division of Surgical Oncology, Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Suite 7150, Philadelphia, PA 19102 USA
| | - Mohammad F. Shaikh
- Division of Surgical Oncology, Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Suite 7150, Philadelphia, PA 19102 USA
| | - Elizabeth M. Gleeson
- Division of Surgical Oncology, Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Suite 7150, Philadelphia, PA 19102 USA
| | - Alvaro Galvez
- Division of Minimally Invasive Surgery, Department of Surgery, Drexel University College of Medicine, 245 N. 15th St, Suite 7150, Philadelphia, PA 19102 USA
| | - Marian Khalili
- Division of Surgical Oncology, Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Suite 7150, Philadelphia, PA 19102 USA
| | - John Lieb
- Division of Gastroenterology & Hepatology, Department of Medicine, Drexel University College of Medicine, 219 N Broad St, 5th Floor, Philadelphia, PA 19107 USA
| | - Elizabeth P. Renza-Stingone
- Division of Minimally Invasive Surgery, Department of Surgery, Drexel University College of Medicine, 245 N. 15th St, Suite 7150, Philadelphia, PA 19102 USA
| | - Wilbur B. Bowne
- Division of Surgical Oncology, Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Suite 7150, Philadelphia, PA 19102 USA
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Courtney MJ, Chattopadhyay D, Rao M, Light D, Gopinath B. Diffuse large B-cell lymphoma (DLBCL) in the bypassed stomach after obesity surgery. Clin Obes 2014; 4:116-20. [PMID: 25826734 DOI: 10.1111/cob.12045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 01/09/2014] [Accepted: 01/15/2014] [Indexed: 12/15/2022]
Abstract
Laparoscopic Roux-en-Y gastric bypass is the most commonly performed surgical procedure for obesity and, consequently, post-operative patients are increasingly encountered by all specialties. This is a case of a patient presenting with abdominal pain, nausea and fever 9 months following gastric bypass surgery caused by diffuse large B-cell lymphoma (DLBCL) in the bypassed stomach. It demonstrates well that symptoms that may normally be considered 'red-flags' may not be as obvious or specific following an operation. The case also indicates the importance of considering diagnoses unrelated to surgery presenting in the post-operative period (especially when conventional investigation methods are not feasible), and the potential danger of assuming they are due to the operation alone; had this occurred in this patient then a malignancy may have been missed. This is only the second reported case of DLBCL in the bypassed stomach, and the third for lymphoma of any type.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Female
- Gastric Bypass
- Humans
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/surgery
- Middle Aged
- Obesity/surgery
- Prednisone/therapeutic use
- Rituximab
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/pathology
- Stomach Neoplasms/surgery
- Vincristine/therapeutic use
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Affiliation(s)
- M J Courtney
- Upper GI/Bariatric Surgery, University Hospital of North Tees, Cleveland, UK
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Kamiński JP, Maker VK, Maker AV. Management of Patients with Abdominal Malignancy after Remote Jejunoileal Bypass: Surgical Considerations Decades Later. J Am Coll Surg 2013; 217:929-39. [DOI: 10.1016/j.jamcollsurg.2013.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/24/2013] [Accepted: 05/24/2013] [Indexed: 01/06/2023]
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