减重手术后胃食管交界腺癌
Adenocarcinoma of the gastroesophageal junction after bariatric surgery.
作者信息
Melstrom Laleh G, Bentrem David J, Salvino Michael J, Blum Matthew G, Talamonti Mark S, Printen Kenneth J
机构信息
Department of Surgery and Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
出版信息
Am J Surg. 2008 Jul;196(1):135-8. doi: 10.1016/j.amjsurg.2007.07.026. Epub 2008 Apr 16.
BACKGROUND
The development of upper gastrointestinal malignancies after bariatric surgery has not been well characterized. Our objective was to review the experience of patients with distal esophageal cancer that was diagnosed after bariatric surgery.
METHODS
A retrospective review was conducted to identify patients who had undergone bariatric surgery (1999 to 2006) and who later developed high-grade dysplasia or adenocarcinoma of the distal esophagus.
RESULTS
Three patients (of 2,875 [0.1%]) developed esophageal cancer: 2 after Roux-en-Y gastric bypass and 1 after vertical banded gastroplasty. All three patients had complaints of reflux, and two were treated with esophagectomy. The third patient presented with invasive carcinoma and died 2 years after diagnosis.
CONCLUSIONS
Our findings emphasize the importance of precise endoscopic evaluation before bariatric surgery in patients with gastroesophageal reflux disease (GERD), of the necessity for continuing postsurgical surveillance in patients with known Barrett's esophagitis, and of early evaluation in patients who develop new symptoms of GERD after bariatric surgery.
背景
减重手术后上消化道恶性肿瘤的发生情况尚未得到充分描述。我们的目的是回顾减重手术后诊断为远端食管癌患者的情况。
方法
进行一项回顾性研究，以确定在1999年至2006年间接受减重手术且后来发生远端食管高级别异型增生或腺癌的患者。
结果
2875例患者中有3例（0.1%）发生食管癌：2例在Roux-en-Y胃旁路术后，1例在垂直束带胃成形术后。所有3例患者均有反流症状，2例接受了食管切除术。第3例患者诊断为浸润性癌，诊断后2年死亡。
结论
我们的研究结果强调了对胃食管反流病（GERD）患者在减重手术前进行精确内镜评估的重要性，对已知患有巴雷特食管炎的患者术后持续监测的必要性，以及对减重手术后出现新的GERD症状的患者进行早期评估的必要性。
Zotero 插件