Reply to Letter Regarding “Barrett’s esophagus and Sleeve Gastrectomy”

2019 ◽  
Vol 29 (12) ◽  
pp. 4064-4065
Author(s):  
Antonio Iannelli ◽  
Sébastien Frey ◽  
Lionel Sebastianelli ◽  
Antonella Santonicola ◽  
Mirto Foletto ◽  
...  
2019 ◽  
Vol 30 (4) ◽  
pp. 1273-1279 ◽  
Author(s):  
Daniel M. Felsenreich ◽  
Felix B. Langer ◽  
Christoph Bichler ◽  
Magdalena Eilenberg ◽  
Julia Jedamzik ◽  
...  

Abstract Background Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett’s esophagus (BE) after SG, its treatment has not been studied, yet. Objectives The aim of this study was to evaluate Roux-en-Y gastric bypass (RYGB) as treatment for BE and reflux after SG. Setting University hospital setting, Austria Methods This multi-center study includes all patients (n = 10) that were converted to RYGB due to BE after SG in Austria. The mean interval between SG and RYGB was 42.7 months. The follow-up after RYGB in this study was 33.4 months. Gastroscopy, 24 h pH-metry, and manometry were performed and patients were asked to complete the BAROS and GIQLI questionnaires. Results Weight and BMI at the time of SG was 120.8 kg and 45.1 kg/m2. Eight patients (80.0%) went into remission of BE after the conversion to RYGB. Two patients had RYGB combined with hiatoplasty. The mean acid exposure time in 24 h decreased from 36.8 to 3.8% and the mean DeMeester score from 110.0 to 16.3. Patients scored 5.1 on average in the BAROS after conversion from SG to RYGB which denotes a very good outcome. Conclusions RYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.


2019 ◽  
Vol 29 (5) ◽  
pp. 1462-1469 ◽  
Author(s):  
Lionel Sebastianelli ◽  
Marine Benois ◽  
Geoffroy Vanbiervliet ◽  
Laurent Bailly ◽  
Maud Robert ◽  
...  

2017 ◽  
Vol 27 (12) ◽  
pp. 3092-3101 ◽  
Author(s):  
Daniel Moritz Felsenreich ◽  
Ronald Kefurt ◽  
Martin Schermann ◽  
Philipp Beckerhinn ◽  
Ivan Kristo ◽  
...  

Author(s):  
Benjamin Medina ◽  
Daniela Molena

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.


2021 ◽  
Vol 93 (2) ◽  
pp. 353-355
Author(s):  
Kevin D. Platt ◽  
Allison R. Schulman

2019 ◽  
Vol 29 (7) ◽  
pp. 2312-2313
Author(s):  
Salvatore Tolone ◽  
Edoardo Savarino ◽  
Nicola De Bortoli ◽  
Ludovico Docimo

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