Table 1.
Studies Included in the Review
| Study | Year | Patients with Neoplasia | Learning Points/Findings |
|---|---|---|---|
| Adams [3] | 2009 | 254 | Reduced cancer incidence and reduced mortality due to cancer in patients after gastric bypass |
| Christou [4] | 2008 | 21 | Reduced physician/hospital visits for common cancers after bariatric surgery |
| Sjöström [5] | 2009 | 117 | Reduced incidence of first time cancers in women but not in men |
| Houghton [19] | 2008 | 5 | Complete or partial regression of Barrett's in 4/5 patients |
| Chang [20] | 2009 | 2 | Macroscopic resolution of Barrett's after RYGB and gastric band |
| Balsiger [21] | 2000 | 25 | Conversion of VBG to RYGB causes resolution of reflux symptoms and no progression of Barrett's to dysplasia |
| Melstrom [23] | 2008 | 3 | Reported Ivor Lewis technique for esophageal adenocarcinoma and feasibility of transhiatal technique for high grade dysplasia in a patients post RYGB. No recurrence in the patient with dysplasia. Follow-up for the operated cancer pt. not reported. |
| Kuruba [24] | 2009 | 1 | Reported Ivor Lewis technique for esophageal adenocarcinoma. Developed brain mets 1 yr later |
| Korswagen [25] | 2009 | 1 | Symptoms of esophageal cancer can mimic symptoms considered ’normal’ in Band patients and high index of suspicion is necessary to detect early stage cancer |
| Stauffer [26] | 2011 | 1 | Symptoms of esophageal cancer can mimic symptoms considered ’normal’ in Band patients and high index of suspicion is necessary to detect early stage cancer |
| Seva-Pereira [28] | 2006 | 1 | Early gastric cancer detected pre-operatively. Open subtotal gastrectomy, D2 lymphadenectomy and Roux-en-Y gastric bypass performed. No recurrence and normal weight loss at 6 months |
| Raijman [29] | 1991 | 1 | Remnant cancer treated by distal gastrectomy - patient died of progressive disease 3 years later |
| Lord [31] | 1997 | 1 | Remnant gastrectomy for gastric remnant cancer, patient was well after 3 months |
| Khitin [32] | 2003 | 1 | Resection of distal part of remnant stomach. Long term follow-up not mentioned |
| Watkins [33] | 2007 | 1 | Remnant gastrectomy for gastric remnant cancer, developed extensive metastasis after 1.5 yrs and finally succumbed |
| Corsini [34] | 2006 | 1 | Patient with intestinal metaplasia pre-operatively develops remnant cancer after RYGB. Gastroenterostomy done for palliation |
| Trincado [35] | 2005 | 1 | Pouch cancer after RYGB - Transhiatal esophagopouchectomy performed. No recurrence after 12 months |
| Babor [36] | 2006 | 1 | Pouch cancer in RYGB- total gastrectomy and esophago- jejunostomy performed. No follow-up reported |
| Chebib [37] | 2007 | 1 | Pouch cancer in VBG- total gastrectomy and esophago- jejunostomy performed. No recurrence after 1 yr follow-up |
| Jain [38] | 2003 | 1 | Pouch cancer in VBG-total gastrectomy with esophago-jejunostomy performed. No recurrence after 6 months of follow-up |
| Papakonstantinou [39] | 2002 | 1 | Gastric cancer in VBG - patient required Whipple procedure. Patient expired after 6 months inspite of chemotherapy |
| Sweet [40] | 1997 | 1 | Linitis plastica after VBG - total gastrectomy. No follow-up reported |
| Zirak [41] | 2002 | 1 | Pouch cancer after silastic VBG - total gastrectomy performed. No recurrence after 1 year |
| Sanchez [42] | 2005 | 4 | All GIST removed by wedge resection during bariatric surgery. No long term follow-up reported. |
| Beltran [46] | 2010 | 1 | GIST removed during laparoscopic sleeve gastrectomy. No followup reported |
| Wang [47] | 2009 | 2 | GIST removed during laparoscopic sleeve gastrectomy. No recurrence after 1 yr |
| De Roover [48] | 2006 | 2 | Malignant GIST after VBG treated with total gastrectomy. Distal recurrence detected after 3 yrs |
| Sohn [52] | 2008 | 11 | Remnant stomachs analysed - chronic or active gastritis in 66, fundic gland polyps in 7, intestinal metaplasia in 3, gastric ulcers in 2, gastropathy in 2, lymphoid aggregate in 1, diverticulum in 1, a developmental cyst in 1, and leiomyoma in 1. |
| Crea [59] | 2011 | 7 | 1.5% incidence of appedicial carcinoids, with 0.6% discovered post-operatively by histopathology. Routine appendectomy or careful inspection of the appendix during surgery was advised. No tumor recurrence after a mean followup of 64 months |
| Keshishian [56] | 2002 | 3 | 3 small bowel carconoids, 1 with abdominal metastasis in which the bariatric surgery was postponed. The patient remaiend asymtopmatic 1 yr after RYGB. Patients in whom RYGB was performed with removal of the small bowel carcinoid remained asymptomatic for>8 months |
| Perryman [81] | 2011 | 1 | Sleeve gastrectomy can be used to include the site of the carcinoid. Normalization of chromogranin A and gastrin levels 2 months after surgery |
| Greenbaum [58] | 2005 | 31 | 400 patients underwent abdominal exploration during bariatric surgery, 25 pathology were related to the ovary, only 3 findings which would change prognosis |
| Lopez-Tomassetti Fernandez [60] | 2007 | 1 | Carcinoid syndrome may be confused with malabsorptive syndrome |
| Gagne [70] | 2009 | 58 | 3.7% incidence of malignancy in their series with 36 present before surgery, 4 detected during pre-op evaluation, 2 suspected during surgery and 16 detected after surgery. Bariatric surgery in general is not contraindicated in the presence of cancer. Treatment of post operative malignancies is not affected by bariatric surgery |
| Helman [63] | 2011 | 1 | Remnant gastrectomy with RYGB done after diagnosis of gastric MALToma. No recurrence after 2 months follow-up |
| Bardaro [71] | 2006 | 1 | RYGB combined with supragastric left adrenalectomy reported. Pt asymptomatic at 6 months follow-up with weight loss as expected |
| Datta [72] | 2010 | 1 | Laparoscopic left adrenalectomy is feasible in antecolic RYGB. Post-operative dexamethasone supression test was normal |
| Varela [73] | 2009 | 1 | Retroperitoneal laparoscopic adrenalectomy in a morbidly obese patient. Asymptomatic with normal BP till 8 mo followup |
| Szymanski [76] | 2011 | 1 | Left hepatectomy feasible in a gastric band patient, weight loss with bariatric surgery to decrease steatosis before hepatecotomy should be considered for benign liver tumors |
| Cáceres [77] | 2009 | 1 | RYGB in the presence of a left lobe liver tumor was not possible, liver resection and bariatric surgery was then performed as a single stage procedure |
| Total Number of Patients | 570 |