Remnant Gastric Cancer After Roux-en-Y Gastric Bypass: Narrative Review of the Literature.
Early diagnosis
Remnant gastric cancer
Roux-en-Y gastric bypass
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
pubmed:
20
4
2019
medline:
16
5
2020
entrez:
20
4
2019
Statut:
ppublish
Résumé
The Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed procedures for surgical weight loss. It has been shown that overweight may be associated with an increased risk of gastric cancer. However, the risk of remnant gastric cancer after RYGB has not been defined yet and the development of neoplasm in the excluded stomach remains a matter of concern. PubMed, EMBASE, and Web of Science databases were consulted. Articles that described the diagnosis and management of remnant gastric cancer after RYGB were considered. Seventeen patients were included. The age of the patient population ranged from 38 to 71 years. The most commonly reported symptoms were abdominal pain, nausea/vomiting, and anemia. Abdominal computed tomography was used for diagnosis in the majority of patients. The neoplasm was located in the antrum/pre-pyloric region in 70% of cases and adenocarcinoma was the most common tumor histology (80%). An advanced tumor stage (III-IV) was diagnosed in almost 70% of patients and 40% were considered unresectable. Gastrectomy with lymphadenectomy was performed in 9 cases (53%). Post-operative morbidity was 12%. The follow-up ranged from 3 to 26 months and the overall disease-related mortality rate was 33.3%. The development of remnant gastric cancer after RYGB is rare. Surgeons should be aware of this potential event and the new onset of epigastric pain, nausea, and anemia should raise clinical suspicion. Further epidemiologic studies are warranted to deeply investigate the post-RYGB-related risk of remnant gastric cancer development in high-risk populations.
Sections du résumé
BACKGROUND
The Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed procedures for surgical weight loss. It has been shown that overweight may be associated with an increased risk of gastric cancer. However, the risk of remnant gastric cancer after RYGB has not been defined yet and the development of neoplasm in the excluded stomach remains a matter of concern.
METHODS
PubMed, EMBASE, and Web of Science databases were consulted. Articles that described the diagnosis and management of remnant gastric cancer after RYGB were considered.
RESULTS
Seventeen patients were included. The age of the patient population ranged from 38 to 71 years. The most commonly reported symptoms were abdominal pain, nausea/vomiting, and anemia. Abdominal computed tomography was used for diagnosis in the majority of patients. The neoplasm was located in the antrum/pre-pyloric region in 70% of cases and adenocarcinoma was the most common tumor histology (80%). An advanced tumor stage (III-IV) was diagnosed in almost 70% of patients and 40% were considered unresectable. Gastrectomy with lymphadenectomy was performed in 9 cases (53%). Post-operative morbidity was 12%. The follow-up ranged from 3 to 26 months and the overall disease-related mortality rate was 33.3%.
CONCLUSION
The development of remnant gastric cancer after RYGB is rare. Surgeons should be aware of this potential event and the new onset of epigastric pain, nausea, and anemia should raise clinical suspicion. Further epidemiologic studies are warranted to deeply investigate the post-RYGB-related risk of remnant gastric cancer development in high-risk populations.
Identifiants
pubmed: 31001760
doi: 10.1007/s11695-019-03892-7
pii: 10.1007/s11695-019-03892-7
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2609-2613Références
Obes Surg. 2005 Mar;15(3):423-7
pubmed: 15826480
Surg Obes Relat Dis. 2019 Jun;15(6):985-994
pubmed: 31104958
Case Rep Surg. 2015;2015:468293
pubmed: 26229705
Obes Surg. 2006 Jul;16(7):928-31
pubmed: 16839496
Surg Obes Relat Dis. 2007 Nov-Dec;3(6):644-7
pubmed: 17950044
Obes Surg. 2009 Oct;19(10):1341-5
pubmed: 19626382
Therap Adv Gastroenterol. 2014 Nov;7(6):247-68
pubmed: 25364384
Am J Surg. 1985 Jan;149(1):151-6
pubmed: 3966631
Obes Surg. 2018 Feb;28(2):497-505
pubmed: 28795271
Gastroenterol Hepatol (N Y). 2010 Dec;6(12):780-92
pubmed: 21301632
Obes Surg. 2017 Aug;27(8):2145-2150
pubmed: 28271378
Acta Chir Belg. 2017 Dec;117(6):391-393
pubmed: 27397038
Obes Surg. 2007 Sep;17(9):1268-71
pubmed: 18074505
Obes Surg. 2006 Jul;16(7):932-4
pubmed: 16839497
J Clin Gastroenterol. 1991 Apr;13(2):191-4
pubmed: 1843447
Obes Surg. 2018 Sep;28(9):2836-2843
pubmed: 29687343
Surg Endosc. 2013 Aug;27(8):2894-9
pubmed: 23793801
Obes Surg. 2015 Oct;25(10):1822-32
pubmed: 25835983
Cureus. 2018 Jun 18;10(6):e2825
pubmed: 30131918
Surg Obes Relat Dis. 2014 Jan-Feb;10(1):e13-4
pubmed: 24126131
Surg Endosc. 2015 Jul;29(7):1753-9
pubmed: 25318366
J Evid Based Soc Work. 2010 Oct;7(5):387-99
pubmed: 21082469
Surg Obes Relat Dis. 2010 Nov-Dec;6(6):670-5
pubmed: 20627707
Aust N Z J Surg. 1997 Aug;67(8):580-2
pubmed: 9287934
Obes Surg. 2018 Sep;28(9):2626-2633
pubmed: 29623665
Curr Surg. 2003 Sep-Oct;60(5):521-3
pubmed: 14972217
Surg Obes Relat Dis. 2014 Mar-Apr;10(2):e15-7
pubmed: 24060402
Gastrointest Endosc. 2017 Oct;86(4):734-736
pubmed: 28389212
JAMA Surg. 2014 Dec;149(12):1323-9
pubmed: 25271405