gms | German Medical Science

Introduction: Among the population of Austria (8,4 Mill.) about 870.000 (12%) have a body mass index (BMI) > 30 kg/m². For those with morbid obesity, Bariatric surgery is currently the only effective treatment in the long term. In 1994 the laparoscopic “Swedish adjustable gastric banding” (SAGB) was introduced in Austria and about 10.200 patients received it so far. One of our SAGB-patients developed adenocarcinoma of the distal esophagus after 13 years. In order to calculate if patients after SAGB are at higher risk for carcinoma of the esophagus, we performed a nationwide survey:

Material and methods: A questionnaire was sent to all surgical departments in Austria, primarily in order to detect cases with esophageal carcinoma after SAGB, but also to evaluate the policy in Austria concerning the preoperative work-up, the operation and the follow-up in SAGB.

Results: Since 1994, 37 out of 124 surgical departments in Austria have been performing about 10200 SAGB implantations in total. Moreover, six surgical departments are performing resective esophageal cancer surgery. Five patients could be identified with development of esophageal carcinoma after SAGB.

Conclusion: Our data suggest that after SAGB, the incidence of esophageal carcinoma might be higher than in the normal population. This will then be discussed be means of the newest nationwide Austrian statistical data on the incidence of esophageal cancer. Moreover, pathophysiologic considerations for esophageal carcinogenesis after SABG including reflux are mentioned in detail.