PDF(Pubmed)
Abstract：
We present the case of a patient who developed esophageal adenocarcinoma after a previous laparoscopic sleeve gastrectomy. Bariatric surgery has emerged as the most effective treatment option for weight loss and obesity-related diseases; however, sleeve gastrectomy promotes gastroesophageal reflux and leads to Barrett\'s esophagus in a substantial portion of patients. The natural history of Barrett\'s esophagus in these patients is unknown, and active surveillance is recommended until the incidence of dysplasia and adenocarcinoma in this population is clarified. Management options for these patients include conversion to Roux-en-Y gastric bypass. Although esophagectomy in patients who have previously undergone sleeve gastrectomy may require an alternative conduit, the remnant stomach can be used in carefully selected patients. Here, we review the different weight loss procedures, their effect on gastroesophageal reflux disease and Barrett\'s esophagus, and the treatment options for patients with esophageal cancer after sleeve gastrectomy. We report the use of preoperative coil embolization as a means of vascular preconditioning before successful use of a gastric conduit.
摘要：
我们介绍了一名患者在先前的腹腔镜袖状胃切除术后发展为食管腺癌的情况。减肥手术已成为减肥和肥胖相关疾病最有效的治疗选择；然而，袖状胃切除术可促进胃食管反流并导致大部分患者出现Barrett食管。这些患者的Barrett食管的自然史未知,并建议积极监测,直至明确该人群中异型增生和腺癌的发病率.这些患者的管理选择包括转换为Roux-en-Y胃旁路术。尽管在先前接受过袖状胃切除术的患者中进行食管切除术可能需要替代导管，残胃可用于精心挑选的患者。这里,我们回顾了不同的减肥程序，它们对胃食管反流病和Barrett食管的影响，以及食管癌患者袖状胃切除术后的治疗选择。我们报告了在成功使用胃导管之前，使用术前线圈栓塞作为血管预处理的一种手段。
