• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Gastroesophageal Reflux is Common After Both Sleeve and Band; GER is Precancerous Lesion; a Warning to Surgeons and Patients: the Band and Sleeve May Lead to GER and Esophageal Cancer

R Rutledge, MD

Center for Laparoscopic Obesity Surgery

The Link between gastroesophageal reflux (GER) and esophageal cancer is undeniable. “There is a strong and causal relation between gastroesophageal reflux and esophageal adenocarcinoma.”(1) Hundreds of other studies support this conclusion.

Therefore an intervention that significantly increases the rate and severity of GER can be predicted to increase the frequency of esophageal cancer.

To study this phenomenon we performed a survey of 112 internationally recognized experts on bariatric surgery to determine their experiences and judgment related to the development of GER following Sleeve and Band

Results
112 surgeons with experience in over 39,000 cases from 23 countries responded.
89% of surgeons reported that “GE Reflux / Nausea & Vomiting is Common” and 55.4% of surgeons agreed that “GE Reflux / Nausea & Vomiting is Common” after sleeve gastrectomy.

When presented with this question: “GERD Increases Risk of Cancer of Esophagus. Longer GERD = More Risk. GERD can cause Barrett’s = even higher risk,” from the American Cancer Society.

With the reference for this quote provided (2): 88.9% of surgeons Agreed but remarkably 11% disagreed? The 11% that disagreed were more likely supporters of the Band and the Sleeve, (Good or Adequate surgery 42.9% and 85.8% respectively)

When presented with question “Numerous Studies Now Show that the Band and the Sleeve can increase acid reflux and be associated with Barretts.”

With these 5 quoted references (3-7) remarkably 21.7% Disagree!

When asked for quantitative data on the incidence of GER after Band or Sleeve, we asked what is the “Postop GE Reflux rate (%)” in Band patients. The surgeons reported that 26.5%, over one quarter of Band patients, suffer GER post op and importantly this is an increase from less than 10% reported with GER preop. In Sleeve patients surgeons reported that the Pre op GE Reflux rate (%) was 8% and post op increased to 27.7%

Conclusions: Although some band and sleeve surgeons may not agree GER is a recognized precursor to esophageal cancer. In addition this survey data confirms other publications that these restrictive and obstructive procedures lead increase of GER in at least 25% of patients. In one study chronic daily reflux symptoms was associated with a 44 fold increase in risk of esophageal cancer. It appears that Sleeve and Band surgeons should warn their patients of the long term risk of GER and esophageal cancer.

(1) Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999 Mar 18;340(11):825-31.
(2) JAMA. 2002 Gastroesophageal reflux, Barrett esophagus, and esophageal cancer. Shaheen N, Ransohoff DF.
(3) Ca.Dis Esoph. 2011 Esophageal adenocarcinoma after laparoscopic gastric band Stauffer et.al..
(4) Ann Surg. 2010 Long-term results of laparoscopic sleeve gastrectomy Himpens J
(5) Obes Facts. 2011; Failure of laparoscopic sleeve gastrectomy Weiner RA, et.al.
(6) Surg Obes Relat Dis. 2011 Gastroesophageal reflux after sleeve gastrectomy Howard D
(7) Obes Surg. 2010 Barrett’s esophagus: a late complication of laparoscopic adjustable gastric banding, Varela J


Session: Poster Presentation

Program Number: P149

110

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons