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腹腔镜袖状胃切除术后五年发生食管腺癌。一例病例报告。

Esophageal adenocarcinoma five years after laparoscopic sleeve gastrectomy. A case report.

作者信息

Wright Fernando Gabriel, Duro Agustin, Medici Juan Rodolfo, Lenzi Santiago, Beskow Axel Federico, Cavadas Demetrio

机构信息

Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD Buenos Aires, Argentina.

出版信息

Int J Surg Case Rep. 2017;32:47-50. doi: 10.1016/j.ijscr.2017.01.054. Epub 2017 Feb 11.

Abstract

INTRODUCTION

Laparoscopic sleeve gastrectomy has become the most popular bariatric procedure worldwide. However, postoperative gastroesophageal reflux disease appearance is a matter of concern. Only two cases of esophageal adenocarcinoma after gastric sleeve have been described, none of them with preoperative endoscopic evaluation.

PRESENTATION OF CASE

We report a case of a 48-year-old male with morbid obesity and normal preoperative endoscopy and esophagram who underwent a laparoscopic sleeve gastrectomy and developed an esophageal adenocarcinoma five years later.

DISCUSSION

Despite promising results in terms of weight loss and resolution of comorbidities, the onset or worsening of gastroesophageal reflux and its related complications, such as Barrett's esophagus or esophageal adenocarcinoma, is a matter of concern and need further study.

CONCLUSION

We present a case of an esophageal adenocarcinoma five years after a laparoscopic sleeve gastrectomy for morbid obesity. There is need to better determine the relationship between sleeve gastrectomy and gastroesophageal reflux disease in order to prevent its related complications, such as esophageal adenocarcinoma.

摘要

引言

腹腔镜袖状胃切除术已成为全球最流行的减肥手术。然而,术后胃食管反流病的出现是一个令人担忧的问题。仅报道过两例胃袖状切除术后发生食管腺癌的病例,均未进行术前内镜评估。

病例介绍

我们报告一例48岁男性,患有病态肥胖症,术前内镜检查和食管造影正常,接受了腹腔镜袖状胃切除术,五年后发生了食管腺癌。

讨论

尽管在减肥和解决合并症方面取得了令人满意的结果,但胃食管反流及其相关并发症(如巴雷特食管或食管腺癌)的发生或恶化仍是一个令人担忧的问题,需要进一步研究。

结论

我们报告一例病态肥胖患者在腹腔镜袖状胃切除术后五年发生食管腺癌的病例。需要更好地确定袖状胃切除术与胃食管反流病之间的关系,以预防其相关并发症,如食管腺癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/185f/5322173/ded39e5e5aa1/gr1.jpg

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