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Baker WA, Laan D. Laparoscopy With Percutaneous Transgastric Endoscopy for the Assessment of Gastric Cancer in the Excluded Stomach of a Roux-en-Y Gastric Bypass Patient. Cureus 2024; 16:e62727. [PMID: 39036261 PMCID: PMC11259526 DOI: 10.7759/cureus.62727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/17/2024] [Indexed: 07/23/2024] Open
Abstract
Primary adenocarcinoma in the excluded stomach of Roux-en-Y gastric bypass (RYGB) patients is extremely rare. As such, the most effective diagnostic approach has not yet been determined. In typical patients, endoscopic ultrasound (EUS) is the first-line technique for evaluating suspected gastric cancer. However, RYGB patients require a more personalized approach. Endoscopic evaluation of the excluded stomach in RYGB patients, whether by EUS-directed, enteroscopy-assisted, or percutaneous means, is undoubtedly more complex than in patients with normal anatomy. In addition, gastric cancer is often diagnosed at an advanced stage due to its asymptomatic early course. With the added complexity of endoscopy in RYGB patients, a laparoscopic-assisted endoscopic approach may have a more favorable diagnostic and therapeutic utility in the case of gastric remnant malignancy in RYGB patients. The following case describes this comprehensive laparoscopic and endoscopic approach for the diagnosis of gastric cancer of the excluded stomach in an RYGB patient.
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Affiliation(s)
- William A Baker
- Bariatric and General Surgery, USA Health Providence Hospital, Mobile, USA
| | - Danuel Laan
- Bariatric and General Surgery, USA Health Providence Hospital, Mobile, USA
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Doukas SG, Doukas PG, Vageli DP, Broder A. Gastric cancer after Bariatric Bypass Surgery. Do they relate? (A Systematic Review). Obes Surg 2023; 33:1876-1888. [PMID: 37041375 DOI: 10.1007/s11695-023-06567-6] [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: 11/13/2022] [Revised: 03/18/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
Bariatric bypass surgery has been an effective treatment for morbid obesity. However, there is an increasing number of reported cases of gastric cancer after bypass surgery. Our systematic review showed an increasing trend of gastric cancer cases after bariatric bypass surgery in the last decade, mostly located in the excluded stomach (77%) and diagnosed in an advanced stage. In addition to known risk factors such as tobacco smoking (17%), H. pylori infection (6%), and family history of gastric cancer (3%), bile reflux, a recently proposed cancer-promoting factor, was also estimated in 18% of the cases. Our data suggest that gastric cancer risk assessment should be considered before gastric bypass surgery, and further investigations are needed to determine the value of post-operative gastric cancer surveillance.
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Affiliation(s)
- Sotirios G Doukas
- Department of Medicine, Division of Gastroenterology and Hepatology, Saint Peter's University Hospital/Rutgers-RWJ Medical School, 254 Easton Avenue, New Brunswick, NJ, 08901, USA.
| | - Panagiotis G Doukas
- Departmengt of Surgery, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Dimitra P Vageli
- Departmengt of Surgery, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Arkady Broder
- Department of Medicine, Division of Gastroenterology and Hepatology, Saint Peter's University Hospital/Rutgers-RWJ Medical School, 254 Easton Avenue, New Brunswick, NJ, 08901, USA
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Tagliaferri AR, Patel D, Cavanagh Y. Gastric Adenocarcinoma of the Remnant Stomach After Roux-en-Y Diagnosed by Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography (EDGE). Cureus 2023; 15:e37697. [PMID: 37206515 PMCID: PMC10191448 DOI: 10.7759/cureus.37697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
It can be difficult to evaluate for pathology with traditional endoscopic modalities following a Roux-en-Y gastric bypass. This is due to the truncated gastrointestinal tract and excluded distal stomach formed during a Roux-en-Y procedure. In these circumstances, a modified endoscopic procedure, known as endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) (EDGE) is used. Although the Roux-en-Y procedure slightly increases the risk of gastric adenocarcinoma in the general population, the occurrence of gastric adenocarcinoma in the excluded stomach, specifically, is uncommon. Herein, we present a case of gastric adenocarcinoma of the excluded stomach, diagnosed 20 years after a Roux-en-Y procedure. This case is unique because after an extensive five-year workup for melena and iron deficiency anemia, the malignancy was ultimately diagnosed utilizing the innovative EDGE procedure.
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Affiliation(s)
| | - Dhruv Patel
- Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA
| | - Yana Cavanagh
- Gastroenterology, St. Joseph's Regional Medical Center, Paterson, USA
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Safatle-Ribeiro AV, Jr UR. Is gastric cancer after bariatric surgery on the rise? Will history repeat itself? Chin J Cancer Res 2023; 35:11-14. [PMID: 36910856 PMCID: PMC9993001 DOI: 10.21147/j.issn.1000-9604.2023.01.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/12/2023] [Indexed: 03/14/2023] Open
Affiliation(s)
- Adriana Vaz Safatle-Ribeiro
- Department of Gastroenterology, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, (ICESP-HCFMUSP) São Paulo, SP 01246-000, Brazil
| | - Ulysses Ribeiro Jr
- Department of Gastroenterology, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, (ICESP-HCFMUSP) São Paulo, SP 01246-000, Brazil
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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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Gupta S, Kalaivani S, Rajasundaram A, Ameta GK, Oleiwi AK, Dugbakie BN. Prediction Performance of Deep Learning for Colon Cancer Survival Prediction on SEER Data. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1467070. [PMID: 35757479 PMCID: PMC9225873 DOI: 10.1155/2022/1467070] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022]
Abstract
Colon and rectal cancers are the most common kinds of cancer globally. Colon cancer is more prevalent in men than in women. Early detection increases the likelihood of survival, and treatment significantly increases the likelihood of eradicating the disease. The Surveillance, Epidemiology, and End Results (SEER) programme is an excellent source of domestic cancer statistics. SEER includes nearly 30% of the United States population, covering various races and geographic locations. The data are made public via the SEER website when a SEER limited-use data agreement form is submitted and approved. We investigate data from the SEER programme, specifically colon cancer statistics, in this study. Our objective is to create reliable colon cancer survival and conditional survival prediction algorithms. In this study, we have presented an overview of cancer diagnosis methods and the treatments used to cure cancer. This paper presents an analysis of prediction performance of multiple deep learning approaches. The performance of multiple deep learning models is thoroughly examined to discover which algorithm surpasses the others, followed by an investigation of the network's prediction accuracy. The simulation outcomes indicate that automated prediction models can predict colon cancer patient survival. Deep autoencoders displayed the best performance outcomes attaining 97% accuracy and 95% area under curve-receiver operating characteristic (AUC-ROC).
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Affiliation(s)
- Surbhi Gupta
- Model Institute of Engineering & Technology, Jammu, J&K, India
| | - S. Kalaivani
- School of Information Technology and Engineering, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Archana Rajasundaram
- Department of Anatomy, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Gaurav Kumar Ameta
- Department of Computer Engineering, Indus Institute of Technology & Engineering, Indus University, Ahmedabad, Gujarat, India
| | - Ahmed Kareem Oleiwi
- Department of Computer Technical Engineering, The Islamic University, 54001 Najaf, Iraq
| | - Betty Nokobi Dugbakie
- Department of Chemical Engineering, Kwame Nkrumah University of Science and Technology (KNUST), Ghana
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