Kuruba Rajesh, Jawad Mohammed, Karl Richard C, Murr Michel M
Weight Management and Metabolic Health Center, University of South Florida Health Sciences Center, Tampa, FL, USA.
Surg Obes Relat Dis. 2009 Sep-Oct;5(5):576-81. doi: 10.1016/j.soard.2009.02.009. Epub 2009 Mar 20.
The number of bariatric procedures has continued to increase worldwide. However, experience with tumors arising in the esophagus or stomach after gastric bypass is lacking. We report our technique for curative resection of esophageal adenocarcinoma in a patient who had undergone previous gastric bypass and review the reported data on esophagogastric tumors after bariatric surgery.
We have described the operative details of esophagectomy after gastric bypass and reviewed the published data regarding type of bariatric surgery, gender predilection, presentation, symptom duration, cancer stage, and prognosis of patients with esophagogastric tumors occurring after bariatric surgery.
Only 22 esophagogastric tumors have been reported so far after bariatric surgery. The majority of them are locally advanced or metastatic at presentation.
Esophagogastric tumors after bariatric surgery are uncommon. This operative technique pays particular attention to the altered anatomy, dissection of the gastric pouch, and preservation of the blood supply to the excluded stomach. This technique can also be applied to manage tumors arising in the gastric pouch after previous gastric bypass. Close collaboration with the bariatric surgeon during surgery is essential to achieve a successful oncologic outcome in this subset of patients.
全球范围内，减肥手术的数量持续增加。然而，对于胃旁路术后食管或胃出现肿瘤的情况，相关经验尚缺。我们报告了对一名曾接受过胃旁路手术的患者进行食管腺癌根治性切除的技术，并回顾了减肥手术后食管胃肿瘤的相关报道数据。
我们描述了胃旁路术后食管切除术的手术细节，并回顾了已发表的关于减肥手术类型、性别偏好、临床表现、症状持续时间、癌症分期以及减肥手术后发生食管胃肿瘤患者预后的数据。
到目前为止，减肥手术后仅报道了22例食管胃肿瘤。其中大多数在就诊时已局部晚期或发生转移。
减肥手术后的食管胃肿瘤并不常见。这种手术技术特别关注解剖结构的改变、胃囊的解剖以及被旷置胃的血供保留。该技术也可用于处理既往胃旁路术后胃囊内出现的肿瘤。手术期间与减肥外科医生密切合作对于在这部分患者中取得成功的肿瘤治疗结果至关重要。
