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Gastro-Intestinal Tract Cancers Following Bariatric Surgery: a Narrative Review

  • Reza Ebrahimi
  • Mohammad KermansaraviEmail author
  • Alireza Khalaj
  • Foolad Eghbali
  • Ali Mousavi
  • Abdolreza Pazouki
Review Article
  • 92 Downloads

Abstract

The association between obesity and malignancies has been identified epidemiologically. Meanwhile, the increasing global number of bariatric surgeries is reported annually; bariatric surgery’s effect on different types of cancers is not well understood. Unfortunately, nonspecific presentations and difficulties regarding investigations make diagnosis challenging. The aim of this study is to compile available data about gastro-intestinal (GI) cancers, occurring after different bariatric surgeries. Although GI cancers are considered a rare complication of obesity surgery, they do exist, and diagnosis needs a high index of suspicion.

Keywords

Bariatric surgery Gastric neoplasms Esophageal neoplasms Colorectal cancer Gastric bypass Sleeve gastrectomy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11695_2019_4007_MOESM1_ESM.docx (16 kb)
Supplementary Table 1 Reported cases of GI cancers following Jejunoileal bypass (JIB) (DOCX 15 kb)
11695_2019_4007_MOESM2_ESM.docx (17 kb)
Supplementary Table 2 Reported cases of GI cancers following vertical banded gastroplasty (VBG) and horizontal gastroplasty (DOCX 17 kb)

References

  1. 1.
    Angrisani L, Santonicola A, Iovino P. Gastric cancer: a de novo diagnosis after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(1):186–7.Google Scholar
  2. 2.
    Menendez P, Villarejo P, Padilla D. Krukenberg tumor after gastric bypass for morbid obesity. Bariatric surgery and gastric cancer. Rev Esp Enferm Dig. 2013;105(5):296–8.Google Scholar
  3. 3.
    Crea N, Pata G, Di Betta E, et al. High incidence of appendix carcinoid tumors among candidates for bariatric surgery: diagnostic and therapeutic implications. Obes Surg. 2011;21(2):151–6.Google Scholar
  4. 4.
    Jawad A, Bar AH, Merianos D, et al. MALT lymphoma of the gastric remnant after Roux-en-Y gastric bypass. J Gastrointest Cancer. 2012;43(1):194–7.Google Scholar
  5. 5.
    Marino KA, Weksler B. Esophagectomy after weight-reduction surgery. Thorac Surg Clin. 2018;28(1):53–8.Google Scholar
  6. 6.
    Braghetto I, Martinez G, Korn O, et al. Laparoscopic subtotal gastrectomy in morbid obese patients: a valid option to laparoscopic gastric bypass in particular circumstances (prospective study). Surg Today. 2018;48(5):558–65.Google Scholar
  7. 7.
    Menendez P, Padilla D, Villarejo P, et al. Does bariatric surgery decrease gastric cancer risk? Hepatogastroenterology. 2012;59(114):409–12.Google Scholar
  8. 8.
    Sainsbury A, Goodlad RA, Perry SL, et al. Increased colorectal epithelial cell proliferation and crypt fission associated with obesity and roux-en-Y gastric bypass. Cancer Epidemiol Biomark Prev. 2008;17(6):1401–10.Google Scholar
  9. 9.
    Vladimirov M, Hesse U, Stein HJ. Gastric carcinoma after sleeve gastrectomy for obesity. Surg Obes Relat Dis. 2017;13(8):1459–61.Google Scholar
  10. 10.
    Abellan I, Ruiz de Angulo D, Parrilla P. Incidental gastric gastrointestinal stromal tumor (GIST) in the excluded stomach after Roux-en-Y gastric bypass: a case report and review of the literature. Surg Obes Relat Dis. 2014;10(1):e13–4.Google Scholar
  11. 11.
    Afshar S, Kelly SB, Seymour K, et al. The effects of bariatric surgery on colorectal cancer risk: systematic review and meta-analysis. Obes Surg. 2014;24(10):1793–9.Google Scholar
  12. 12.
    Masrur M, Elli E, Gonzalez-Ciccarelli LF, et al. De novo gastric adenocarcinoma 1 year after sleeve gastrectomy in a transplant patient. Int J Surg Case Rep. 2016;20:10–3.Google Scholar
  13. 13.
    Rogers AM, Capen J, Galka E, et al. Tubulovillous adenoma with atypia found at gastrojejunal anastomosis 8 years after gastric bypass for morbid obesity. Surg Obes Relat Dis. 2007;3(5):559–60.Google Scholar
  14. 14.
    van de Vrande S, Himpens J, Leman G. Adenocarcinoma of the gastric pouch after Roux-en-Y gastric bypass: a new technique for en bloc resection and reconstruction. Surg Obes Relat Dis. 2017;13(10):1793–5.Google Scholar
  15. 15.
    Tao W, Konings P, Hull MA, et al. Colorectal cancer prognosis following obesity surgery in a population-based cohort study. Obes Surg. 2017;27(5):1233–9.Google Scholar
  16. 16.
    Morris L, Beketaev I, Barrios R, et al. Colon adenocarcinoma after jejunoileal bypass for morbid obesity. J Surg Case Rep. 2017;2017(11):rjx214.Google Scholar
  17. 17.
    Burton Jr JR, Katon R. Anterograde colonoscopy: per oral diagnosis of colon cancer with an enteroscope in a man with a jejunoileal bypass. Gastrointest Endosc. 2003;57(7):982–3.Google Scholar
  18. 18.
    Voss S, Russell T. Carcinoma as a possible complication of jejunoileal bypass operation. West J Med. 1984;141(5):686.Google Scholar
  19. 19.
    McFarland RJ, Talbot RW, Woolf N, et al. Dysplasia of the colon after jejuno-ileal bypass. Br J Surg. 1987;74(1):21–2.Google Scholar
  20. 20.
    Sylvan A, Sjolund B, Janunger KG, et al. Colorectal cancer risk after jejunoileal bypass: dysplasia and DNA content in longtime follow-up of patients operated on for morbid obesity. Dis Colon Rectum. 1992;35(3):245–8.Google Scholar
  21. 21.
    Papakonstantinou A, Moustafellos P, Terzis I, et al. Gastric cancer occurring after vertical banded gastroplasty. Obes Surg. 2002;12(1):118–20.Google Scholar
  22. 22.
    Zirak C, Lemaitre J, Lebrun E, et al. Adenocarcinoma of the pouch after silastic ring vertical gastroplasty. Obes Surg. 2002;12(5):693–4.Google Scholar
  23. 23.
    Sweet WA. Linitis plastica presenting as pouch outlet stenosis 13 years after vertical banded gastroplasty. Obes Surg. 1996;6(1):66–70.Google Scholar
  24. 24.
    Allen JW, Leeman MF, Richardson JD. Esophageal carcinoma following bariatric procedures. JSLS. 2004;8(4):372–5.Google Scholar
  25. 25.
    de Roover A, Detry O, de Leval L, et al. Report of two cases of gastric cancer after bariatric surgery: lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty. Obes Surg. 2006;16(7):928–31.Google Scholar
  26. 26.
    Jain PK, Ray B, Royston CM. Carcinoma in the gastric pouch years after vertical banded gastroplasty. Obes Surg. 2003;13(1):136–7.Google Scholar
  27. 27.
    Melstrom LG, Bentrem DJ, Salvino MJ, et al. Adenocarcinoma of the gastroesophageal junction after bariatric surgery. Am J Surg. 2008;196(1):135–8.Google Scholar
  28. 28.
    Snook KL, Ritchie JD. Carcinoma of esophagus after adjustable gastric banding. Obes Surg. 2003;13(5):800–2.Google Scholar
  29. 29.
    Hackert T, Dietz M, Tjaden C, et al. Band erosion with gastric cancer. Obes Surg. 2004;14(4):559–61.Google Scholar
  30. 30.
    Korswagen LA, Schrama JG, Bruins Slot W, et al. Adenocarcinoma of the lower esophagus after placement of a gastric band. Obes Surg. 2009;19(3):389–92.Google Scholar
  31. 31.
    Stroh C, Hohmann U, Urban H, et al. Gastric cancer after laparoscopic adjustable gastric banding. Obes Surg. 2008;18(9):1200–2.Google Scholar
  32. 32.
    Stauffer JA, Mathew J, Odell JA. Esophageal adenocarcinoma after laparoscopic gastric band placement for obesity. Dis Esophagus. 2011;24(1):E8–10.Google Scholar
  33. 33.
    Szymanski D, Durczynski A, Strzelczyk J. Two-staged surgery for metastatic liver tumor in morbidly obese individual-left hemihepatectomy following placement of laparoscopic adjustable gastric band. Obes Surg. 2011;21(2):267–71.Google Scholar
  34. 34.
    Graca SA, Costa S, Ferreira J, et al. Port--site metastases following bariatric surgery. BMJ Case Rep. 2011;2011Google Scholar
  35. 35.
    Orlando G, Pilone V, Vitiello A, et al. Gastric cancer following bariatric surgery: a review. Surg Laparosc Endosc Percutan Tech. 2014;24(5):400–5.Google Scholar
  36. 36.
    Scheepers AF, Schoon EJ, Nienhuijs SW. Esophageal carcinoma after sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(4):e11–e2.Google Scholar
  37. 37.
    Küper MA, Königsrainer I, Schmidt D, et al. Morbid obesity and subsequent pancreatic cancer: pylorus-preserving pancreatoduodenectomy after laparoscopic sleeve gastrectomy. Obes Surg. 2009;19(3):385–8.Google Scholar
  38. 38.
    Khitin L, Roses RE, Birkett DH. Cancer in the gastric remnant after gastric bypass: a case report. Curr Surg. 2003;60(5):521–3.Google Scholar
  39. 39.
    Escalona A, Guzman S, Ibanez L, et al. Gastric cancer after Roux-en-Y gastric bypass. Obes Surg. 2005;15(3):423–7.Google Scholar
  40. 40.
    Trincado MT, del Olmo JC, Garcia Castano J, et al. Gastric pouch carcinoma after gastric bypass for morbid obesity. Obes Surg. 2005;15(8):1215–7.Google Scholar
  41. 41.
    Corsini DA, Simoneti CA, Moreira G, et al. Cancer in the excluded stomach 4 years after gastric bypass. Obes Surg. 2006;16(7):932–4.Google Scholar
  42. 42.
    Vanek VW, Catania M, Triveri K, et al. Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery. Surg Obes Relat Dis. 2006;2(1):17–22.Google Scholar
  43. 43.
    Nguyen NT, Kim E. Consideration for esophagectomy in patients with prior bariatric surgery. Obes Surg. 2016;26(4):727–9.Google Scholar
  44. 44.
    Watkins BJ, Blackmun S, Kuehner ME. Gastric adenocarcinoma after Roux-en-Y gastric bypass: access and evaluation of excluded stomach. Surg Obes Relat Dis. 2007;3(6):644–7.Google Scholar
  45. 45.
    Csendes A. Roux-en-Y after gastric bypass. Arch Surg. 2008;143(8):808. author replyGoogle Scholar
  46. 46.
    Khithani AS, Curtis DE, Galanopoulos C, et al. Pancreaticoduodenectomy after a Roux-en-Y gastric bypass. Obes Surg. 2009;19(6):802–5.Google Scholar
  47. 47.
    Kuruba R, Jawad M, Karl RC, et al. Technique of resection of esophageal adenocarcinoma after Roux-en-Y gastric bypass and literature review of esophagogastric tumors after bariatric procedures. Surg Obes Relat Dis. 2009;5(5):576–81.Google Scholar
  48. 48.
    Court I, Zissman P, Rosenthal RJ. Diagnosis and treatment of Zollinger Ellison syndrome in a morbidly obese patient after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2010;6(6):714–7.Google Scholar
  49. 49.
    Sourianarayanane A, Mukewar SS, Upchurch BR, et al. Double-balloon enteroscopy enabled the diagnosis of duodenal adenocarcinoma in a patient with Roux-en-Y gastric bypass surgery presenting with chronic anemia. Gastrointest Endosc. 2011;73(4):837–8.Google Scholar
  50. 50.
    Kulaylat AN, Sahajwani S, Staveley-O'Carroll KF, et al. Reconstructive options for gastroesophageal junction adenocarcinoma after Roux-en-Y gastric bypass. J Thorac Cardiovasc Surg. 2013;146(5):1296–8.Google Scholar
  51. 51.
    Courtney MJ, Chattopadhyay D, Rao M, et al. Diffuse large B-cell lymphoma (DLBCL) in the bypassed stomach after obesity surgery. Clin Obes. 2014;4(2):116–20.Google Scholar
  52. 52.
    Nau P, Rattner DW, Meireles O. Linitis plastica presenting two years after elective Roux-en-Y gastric bypass for treatment of morbid obesity: a case report and review of the literature. Surg Obes Relat Dis. 2014;10(2):e15–7.Google Scholar
  53. 53.
    Magge D, Holtzman MP. Gastric adenocarcinoma in patients with Roux-en-Y gastric bypass: a case series. Surg Obes Relat Dis. 2015;11(5):e35–e8.Google Scholar
  54. 54.
    Haenen FW, Gys B, Moreels T, et al. Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: a case report. Acta Chir Belg. 2017;117(6):391–3.Google Scholar
  55. 55.
    Wu CC, Lee WJ, Ser KH, et al. Gastric cancer after mini-gastric bypass surgery: a case report and literature review. Asian J Endosc Surg. 2013;6(4):303–6.Google Scholar
  56. 56.
    Lord RV, Edwards PD, Coleman MJ. Gastric cancer in the bypassed segment after operation for morbid obesity. Aust N Z J Surg. 1997;67(8):580–2.Google Scholar
  57. 57.
    Raijman I, Strother SV, Donegan WL. Gastric cancer after gastric bypass for obesity. Case report. J Clin Gastroenterol. 1991;13(2):191–4.Google Scholar
  58. 58.
    Babor R, Booth M. Adenocarcinoma of the gastric pouch 26 years after loop gastric bypass. Obes Surg. 2006;16(7):935–8.Google Scholar
  59. 59.
    Fernández EL-T, González IA, Luis HD, et al. Carcinoid syndrome misdiagnosed as a malabsorptive syndrome after biliopancreatic diversion. Obes Surg. 2007;17(7):989–92.Google Scholar
  60. 60.
    López-Tomassetti Fernández EM, Hernández Hernández JR, Jorge VN. Right colon carcinoma infiltrating the alimentary limb in a patient with biliopancreatic diversion. Int Surg. 2014;99(4):354–8.Google Scholar
  61. 61.
    Adami GF, Papadia FS, Marinari GM, et al. Does biliopancreatic diversion carry increased risk for colorectal cancer? A cohort study. Obes Surg. 2008;18(2):212–5.Google Scholar
  62. 62.
    Bristol J, Wells M, Williamson R. Adaptation to jejunoileal bypass promotes experimental colorectal carcinogenesis. Br J Surg. 1984;71(2):123–6.Google Scholar
  63. 63.
    Olubuyide I, Bristol J, Williamson R. Goblet cell changes during intestinal adaptation to azoxymethane and enteric bypass in the rat. Br J Cancer. 1985;51(3):383.Google Scholar
  64. 64.
    Balsiger BM, Muru MM, Mai J, et al. Gastroesophageal reflux after intact vertical banded gastroplasty: correction by conversion to Roux-en-Y gastric bypass. J Gastrointest Surg. 2000;4(3):276–81.Google Scholar
  65. 65.
    Chebib I, Beck P, Church N, et al. Gastric pouch adenocarcinoma and tubular adenoma of the pylorus: a field effect of dysplasia following bariatric surgery. Obes Surg. 2007;17(6):843–6.Google Scholar
  66. 66.
    De Roover A, Detry O, Desaive C, et al. Risk of upper gastrointestinal cancer after bariatric operations. Obes Surg. 2006;16(12):1656–61.Google Scholar
  67. 67.
    Povoski SP, Chang WW. Gastric schwannoma found incidentally 19 years after a horizontal gastroplasty for morbid obesity. Obes Surg. 2001;11(6):762–5.Google Scholar
  68. 68.
    Ovrebø K, Hatlebakk JG, Viste A, et al. Gastroesophageal reflux in morbidly obese patients treated with gastric banding or vertical banded gastroplasty. Ann Surg. 1998;228(1):51.Google Scholar
  69. 69.
    Forsell P, Hallerbäck B, Glise H, et al. Complications following Swedish adjustable gastric banding: a long-term follow-up. Obes Surg. 1999;9(1):11–6.Google Scholar
  70. 70.
    Kant P, Perry SL, Dexter SP, et al. Mucosal biomarkers of colorectal cancer risk do not increase at 6 months following sleeve gastrectomy, unlike gastric bypass. Obesity (Silver Spring). 2014;22(1):202–10.Google Scholar
  71. 71.
    Yuval JB, Elazary R. The true incidence of gastric GIST: an update. Obes Surg. 2018;28(6):1787Google Scholar
  72. 72.
    Yuval JB, Khalaileh A, Abu-Gazala M, et al. The true incidence of gastric GIST—a study based on morbidly obese patients undergoing sleeve gastrectomy. Obes Surg. 2014;24(12):2134–7.Google Scholar
  73. 73.
    Papadia FS, Scopinaro N. Gastric cancer and Roux-en-Y gastric bypass. Obes Surg. 2006;16(11):1552.Google Scholar
  74. 74.
    Rossidis G, Browning R, Hochwald SN, et al. Minimally invasive esophagectomy is safe in patients with previous gastric bypass. Surg Obes Relat Dis. 2014;10(1):95–100.Google Scholar
  75. 75.
    Harper JL, Beech D, Tichansky DS, et al. Cancer in the bypassed stomach presenting early after gastric bypass. Obes Surg. 2007;17(9):1268–71.Google Scholar
  76. 76.
    Sun C, Jackson CS, Reeves M, et al. Metastatic adenocarcinoma of the gastric pouch 5 years after Roux-en-Y gastric bypass. Obes Surg. 2008;18(3):345–8.Google Scholar
  77. 77.
    Inoue H, Rubino F, Shimada Y, et al. Risk of gastric cancer after Roux-en-Y gastric bypass. Arch Surg. 2007;142(10):947–53.Google Scholar
  78. 78.
    Ghanem M, Teixeira AF, Jawad MA. Resection of the excluded stomach due to severe bleeding immediately after Roux-en-Y gastric bypass in a patient with Lynch syndrome: a case report. Surg Obes Relat Dis. 2017;13(5):e21–e3.Google Scholar
  79. 79.
    Mahawar KK, Borg C-M, Kular KS, et al. Understanding objections to one anastomosis (mini) gastric bypass: a survey of 417 surgeons not performing this procedure. Obes Surg. 2017;27(9):2222–8.Google Scholar
  80. 80.
    Bruzzi M, Chevallier J-M, Czernichow S. One-anastomosis gastric bypass: why biliary reflux remains controversial? Obes Surg. 2017;27(2):545–7.Google Scholar
  81. 81.
    Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27(5):1153–67.Google Scholar
  82. 82.
    Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.Google Scholar
  83. 83.
    Mahawar KK. Reviews on one anastomosis gastric bypass. Obes Surg. 2016;26(11):2788.Google Scholar
  84. 84.
    Mottin CC, Cruz RP, Gomes Thome G, et al. Carcinoid tumors and morbid obesity. Obes Surg. 2009;19(2):247–9.Google Scholar
  85. 85.
    Keshishian A, Hamilton J, Hwang L, et al. Carcinoid tumor and bariatric surgery. Obes Surg. 2002;12(6):874–5.Google Scholar
  86. 86.
    Aminian A, Schauer PR, Brethauer SA. Malignant gastric carcinoid tumor and morbid obesity. Surg Obes Relat Dis. 2014;10(6):1237.Google Scholar
  87. 87.
    Erim T, Colak Y, Szomstein S. Gastric carcinoid tumor after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(6):e51–2.Google Scholar
  88. 88.
    Kassir R, Lointier P, Breton C, et al. Postoperative finding of gastric neuroendocrine tumor in a patient undergoing a mini gastric bypass: points to consider. Surg Obes Relat Dis. 2014;10(5):1009–11.Google Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Minimally Invasive Surgery Research CenterIran University of Medical SciencesTehranIran
  2. 2.Center of Excellence of International Federation for Surgery of ObesityHazrat e Rasool HospitalTehranIran
  3. 3.Tehran Obesity Treatment Center, Department of Surgery, Faculty of MedicineShahed UniversityTehranIran

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