Esophageal adenocarcinoma after sleeve gastrectomy: actual or potential threat? Italian series and literature review.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
May 2021
Historique:
received: 27 07 2020
revised: 23 11 2020
accepted: 23 11 2020
pubmed: 1 1 2021
medline: 25 5 2021
entrez: 31 12 2020
Statut: ppublish

Résumé

Sleeve gastrectomy (SG) leads to esophageal mucosal damage in an elevated percentage of cases, configuring a clinical condition of Barrett's esophagus (BE) in a proportion as high as 15-18.8%. BE may rarely evolve into esophageal adenocarcinoma (EAC). To raise awareness of BE as a precancerous lesion which may progress toward malignancy after this popular bariatric procedure. Bariatric referral centers, Italy. All patients referred to our bariatric center who developed an EAC after SG between 2012 and 2019 were reviewed and consecutively included in this study. The available scientific literature regarding this complication is additionally reviewed. The 3 male patients comprised in this case series underwent laparoscopic SG between 2012 and 2015 in different bariatric referral centers. Age and body mass index at baseline ranged from 21-54 years and 43.1-75.6 kg/m Although the rate and probability of progression from BE to EAC is still not well defined, assuming that the rising popularity and execution of SG leads to a growth in the BE incidence, then the preoperative identification and stratification of cancer risk factors in this subset of patients is strongly encouraged. Clinical and endoscopic follow-ups are essential to allow for prevention and early diagnosis and for epidemiologic data collection purposes.

Sections du résumé

BACKGROUND BACKGROUND
Sleeve gastrectomy (SG) leads to esophageal mucosal damage in an elevated percentage of cases, configuring a clinical condition of Barrett's esophagus (BE) in a proportion as high as 15-18.8%. BE may rarely evolve into esophageal adenocarcinoma (EAC).
OBJECTIVES OBJECTIVE
To raise awareness of BE as a precancerous lesion which may progress toward malignancy after this popular bariatric procedure.
SETTING METHODS
Bariatric referral centers, Italy.
METHODS METHODS
All patients referred to our bariatric center who developed an EAC after SG between 2012 and 2019 were reviewed and consecutively included in this study. The available scientific literature regarding this complication is additionally reviewed.
RESULTS RESULTS
The 3 male patients comprised in this case series underwent laparoscopic SG between 2012 and 2015 in different bariatric referral centers. Age and body mass index at baseline ranged from 21-54 years and 43.1-75.6 kg/m
CONCLUSION CONCLUSIONS
Although the rate and probability of progression from BE to EAC is still not well defined, assuming that the rising popularity and execution of SG leads to a growth in the BE incidence, then the preoperative identification and stratification of cancer risk factors in this subset of patients is strongly encouraged. Clinical and endoscopic follow-ups are essential to allow for prevention and early diagnosis and for epidemiologic data collection purposes.

Identifiants

pubmed: 33380354
pii: S1550-7289(20)30684-5
doi: 10.1016/j.soard.2020.11.023
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

848-854

Commentaires et corrections

Type : CommentIn
Type : CommentIn
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Informations de copyright

Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Alfredo Genco (A)

Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.

Lidia Castagneto-Gissey (L)

Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: lidia.castagnetogissey@uniroma1.it.

Michele Lorenzo (M)

Azienda Ospedaliera Locale Napoli 3 (ASLNA3), Distretto Sanitario 56 (DS56), Unità Operativa Medicina Legale (UOML), Torre Annunziata, Naples, Italy.

Ilaria Ernesti (I)

Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.

Emanuele Soricelli (E)

Department of Surgery, Bariatric and Metabolic Surgery Unit, Santa Maria Nuova Hospital, Florence, Italy.

Giovanni Casella (G)

Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.

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Classifications MeSH