Laparoscopic Approach to Barrett Carcinoma in an Obese Patient
Georg Wiltberger, MD, Felix Krenzien, MD, Hans-Michael Hau, MD, Hans-Michael Tautenhahn,
Albrecht Hoffmeister, MD, Sven Jonas, MD, Arne Dietrich, MD
Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany (Drs. Wiltberger, Krenzien, Hau, Tautenhahn, Jonas, Dietrich).
Department of Medicine, Dermatology and Neurology, Division of Gastroenterology and Rheumatology, University of Leipzig, Leipzig, Germany (Dr. Hoffmeister)ABSTRACT
We report an obese patient who was initially scheduled for laparoscopic Roux-en-Y gastric bypass, but who was subsequently diagnosed preoperatively with Barrett carcinoma. After incomplete endoscopic mucosectomy, laparoscopic oncologic resection (transhiatal extended cardia resection) combined with bariatric reconstruction was performed. Sufficient complication management of a small anastomotic leak into the right pleural space was maintained with a combination of video-assisted thoracoscopy and endoscopic clipping of the leak.
Key Words: Barrett carcinoma, Bariatric surgery, LRYGB, Merendino