El Khoury Lionel, Benvenga Rosa, Romero Rodolfo, Cohen Regis, Roussel Joel, Catheline Jean-Marc
Department of Digestive Surgery, Centre Hospitalier de Saint-Denis, 2 Rue du Docteur Delafontaine, 93205, Saint-Denis, France.
Int J Surg Case Rep. 2018;52:132-136. doi: 10.1016/j.ijscr.2018.10.015. Epub 2018 Oct 12.
Sleeve gastrectomy (SG) has become one of the most dramatically increasing bariatric procedures worldwide due to its excellent results and impact on the obesity pandemic. Morbid obesity is known to increase the risk of esophageal adenocarcinoma. However, the evolution of gastroesophageal reflux disease (GERD) along with Barrett's esophagus (BE) after SG is of concern since there is little data available. We present a case of esophageal adenocarcinoma after SG with known intestinal metaplasia on preoperative gastroscopy.
We report a case of a 55 years old female patient who presented lower esophageal adenocarcinoma three years after complicated SG with known preoperative BE without dysplasia detected by gastroscopy. Multidisciplinary decision suggested treatment by endoscopic mucosectomy. The endoscopic control at one year did not highlight tumoral recurrence but still BE without dysplasia.
Literature review regarding the evolution of BE after SG is poor and the relation between SG and the development of subsequent esophageal cancer isn't clear yet.
Preoperative endoscopy should be performed in order to detect GERD, BE, and potential carcinomas of the upper gastrointestinal tract before undergoing bariatric surgery. The long-term monitoring after SG is essential.
由于袖状胃切除术（SG）效果卓越且对肥胖流行产生影响，它已成为全球范围内增长最为显著的减肥手术之一。众所周知，病态肥胖会增加食管腺癌的风险。然而，由于可用数据较少，SG术后胃食管反流病（GERD）以及巴雷特食管（BE）的演变情况令人担忧。我们报告一例SG术后发生食管腺癌的病例，术前胃镜检查发现存在肠化生。
我们报告一例55岁女性患者，在复杂的SG术后三年出现食管下段腺癌，术前胃镜检查发现存在BE但无发育异常。多学科决策建议采用内镜下黏膜切除术进行治疗。一年后的内镜检查未发现肿瘤复发，但仍存在无发育异常的BE。
关于SG术后BE演变的文献综述较少，且SG与后续食管癌发生之间的关系尚不清楚。
在进行减肥手术前，应进行术前内镜检查以检测GERD、BE以及上消化道潜在的癌症。SG术后的长期监测至关重要。
