Does Bariatric Surgery Increase the Risk of Gastroesophageal Cancer?
Menée en France à l'aide de données hospitalières 2010-2017 portant sur 605 140 témoins et 303 709 patients ayant eu recours à une chirurgie bariatrique (durée moyenne de suivi : 5,62 ans ; âge moyen : 40,2 ans ; 80,9 % de femmes), cette étude analyse l'effet de la chirurgie sur le risque de cancer de l'estomac ou de l'oesophage lié à l'obésité (337 cas)
Bariatric surgery has been proven to provide patients with morbid obesity a substantial and sustained weight loss, improvement or even remission of certain obesity-related comorbidities, and overall improvement in life expectancy. As the popularity of more recent weight loss procedures, such as sleeve gastrectomy, increases, there is growing concern that their mechanism and restrictive nature may contribute to increasing the incidence of clinical gastroesophageal reflux disease (GERD) and hastening its progression to Barrett esophagus and potentially adenocarcinoma. Even if these phenomena were very rare, if shown to have statistical significance, they represent a concern requiring more studies and clarification. While bariatric surgery has been associated with reduced overall risk of developing certain cancers, increased GERD-based metaplasia and its known progression to adenocarcinoma of the distal esophagus and gastroesophageal junction should pose a higher risk.