title: Early gastric cancer found at preoperative assessment for bariatric surgery.
abstract: An association between gastric cancer and obesity has been suggested in large epidemiologic series. We present a 61-year-old lady with BMI 48.7 kg/m2, who underwent preoperative work-up for Roux-en-Y gastric bypass. Her endoscopy showed a depressed lesion at the incisura angularis, suggesting early gastric cancer. The biopsy confirmed well/moderately-differentiated adenocarcinoma. The surgical approach was subtotal gastrectomy leaving only part of the fundus, and was performed on an oncological basis, with lymphatic D2 dissection. The gastro-enterostomy was 1.5 cm wide, and was constructed closer to the greater curvature over a 12-Fr Fouchet tube. The reconstruction was in a Roux-en-Y fashion, but the alimentary limb was 150 cm long. Despite the short follow-up, the way the surgery was conducted presumably maintained both oncologic and bariatric determinations.
authors.affiliation: Department of Surgery, Pró-Gastro Institute, Campinas, SP, Brazil. gustavo@progastro.med.br
authors.forename: Gustavo
authors.initials: G
authors.lastname: Sevá-Pereira
authors.forename: Vilmar Luis
authors.initials: VL
authors.lastname: Trombeta
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D011300:Preoperative Care; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery