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Laparoscopic transhiatal esophagectomy for esophageal adenocarcinoma identified at laparoscopic Roux-en-Y gastric bypass.

Ellison HB, Parker DM, Horsley RD, McField D, Friscia ME, Petrick AT - Int J Surg Case Rep (2016)

Bottom Line: The cost effectiveness of this strategy is questionable.Our institution has opted for selective preoperative endoscopy in patients with preoperative gastrointestinal symptoms.In post gastric bypass patients LTHE can be performed with good results.

View Article: PubMed Central - PubMed

Affiliation: Geisinger Medical Center, Department of General Surgery, 100 North Academy Ave., Danville PA, 17821, United States.

No MeSH data available.


Related in: MedlinePlus

Esophageal mass at 33 cm.
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fig0005: Esophageal mass at 33 cm.

Mentions: The first patient was a 66 year old male with a BMI of 48 kg/m2 at presentation. His obesity related comorbidities included obstructive sleep apnea (OSA), diabetes mellitus (DM), hypertension (HTN), dyslipidemia, non-alcoholic fatty liver disease and degenerative joint disease. He did not have a history of GERD and was not on acid suppressive therapy. He was a former cigarette smoker who quit 13 years prior to evaluation for bariatric surgery. His risk factors for EA included age, gender, Body Mass Index (BMI) and history of tobacco use. He underwent a laparoscopic RYGB with routine completion intraoperative endoscopy for anastomotic surveillance and leak testing. A mass, concerning for EA, was identified at 33 cm from the incisors (Fig. 1). A biopsy was obtained and intra-operative endoscopic ultrasound (EUS) was performed. The lesion was staged T1N0 by endosonographic criteria. Pathology demonstrated a well to moderately differentiated invasive adenocarcinoma arising in a background of Barrett’s esophagus (BE) with high grade dysplasia. Her-2-Neu was not amplified. A post operative a positron emission tomography-computed tomography (PET-CT) was completed and the patient was restaged as IA (T1bN0M0).


Laparoscopic transhiatal esophagectomy for esophageal adenocarcinoma identified at laparoscopic Roux-en-Y gastric bypass.

Ellison HB, Parker DM, Horsley RD, McField D, Friscia ME, Petrick AT - Int J Surg Case Rep (2016)

Esophageal mass at 33 cm.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4933034&req=5

fig0005: Esophageal mass at 33 cm.
Mentions: The first patient was a 66 year old male with a BMI of 48 kg/m2 at presentation. His obesity related comorbidities included obstructive sleep apnea (OSA), diabetes mellitus (DM), hypertension (HTN), dyslipidemia, non-alcoholic fatty liver disease and degenerative joint disease. He did not have a history of GERD and was not on acid suppressive therapy. He was a former cigarette smoker who quit 13 years prior to evaluation for bariatric surgery. His risk factors for EA included age, gender, Body Mass Index (BMI) and history of tobacco use. He underwent a laparoscopic RYGB with routine completion intraoperative endoscopy for anastomotic surveillance and leak testing. A mass, concerning for EA, was identified at 33 cm from the incisors (Fig. 1). A biopsy was obtained and intra-operative endoscopic ultrasound (EUS) was performed. The lesion was staged T1N0 by endosonographic criteria. Pathology demonstrated a well to moderately differentiated invasive adenocarcinoma arising in a background of Barrett’s esophagus (BE) with high grade dysplasia. Her-2-Neu was not amplified. A post operative a positron emission tomography-computed tomography (PET-CT) was completed and the patient was restaged as IA (T1bN0M0).

Bottom Line: The cost effectiveness of this strategy is questionable.Our institution has opted for selective preoperative endoscopy in patients with preoperative gastrointestinal symptoms.In post gastric bypass patients LTHE can be performed with good results.

View Article: PubMed Central - PubMed

Affiliation: Geisinger Medical Center, Department of General Surgery, 100 North Academy Ave., Danville PA, 17821, United States.

No MeSH data available.


Related in: MedlinePlus