[AC] General Upper Abdominal Surgery Flashcards
A Gastrectomy is
The removal of the stomach
A oesophagogastrectomy is
Removal of the lower part of the oesophagus and entire stomach with oesophago - jejunostomy via laparotomy or thoracoabdominal incision
A bowel resection is a surgical procedure in which
A part of the large or small intestine is removed.
What is an abdominal aortic aneurysm repair?
A procedure used to treat an aneurysm (abnormal enlargement) of the abdominal aorta.
What is anaemia? Why does this occur from surgery?
Decrease in the number of red blood cells.
Could because of blood/fluid loss in theatre, in which can blood transfusion can be used to restore Hb levels in severe anaemic patients
A central venous catheter (or ‘central line’) is usually placed in surgery and is a ____
catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian or axillary) or groin (femoral). It used to administer medication or fluids, obtain blood tests (specifically the ‘central venous oxygen saturation’) and measure central venous pressure
Some risk factors associated with oesophageal cancer?
Heavy alcohol use in conjunction with cigarette smoking or chewing tobacco
Some research of a genetic component
What is the most common initial symptom of oesophageal cancer?
Dysphagia (difficulty swallowing) but usually occurs in late stage oesophageal cancer
The most common surgical procedures for oesophageal cancer are:
transhiatal (trans-hiatal) esophagectomy and transthoracic esophagectomy
Transhiatal Esophagectomy involves
Both an abdominal incision and a cervical (neck) incision. The thoracic cavity is not opened (thus less likely of PPC’s)
Transthoracic esophagectomy involves an
abdominal incision and a thoracotomy. The mid and lower parts of the oesophagus are removed along with the upper part of the stomach
The choice of what kind of operation the surgeon does for oesophageal cancer depends on
the location of the tumour; the patient’s pulmonary function, and the surgeon’s experience and preference
After esophagectomy, patients go to an
intensive care unit for 24 to 48 hours. They are usually intubated and have multiple drains and tubes.
Initial pain management of esophagectomy may include
epidurally, patient-controlled analgesia with morphine
Patients are nil by mouth for 5-7 days following esophagectomy therefore medication is provided via
intraveous or epidurally
We can initiate coughing, deep breathing, incentive spirometery after an esophagectomy patient has been
extubated
Early mobilisation for a patient after esophagectomy will reduce the pulmonary risk of
atelectasis, a precursor to pneumonia
We should check chest tube sites for
Drainage, and ensure the chest tube dressing is clean, dry and intact
Depending on the type of surgery, a chest tube may be in place. For patients with chest tubes we should assess the
drainage every shift. Expect no more than 100 to 200 mL/h on the first day. Drainage should decrease gradually
Generally, all patients have a nasogastric tube after esophagectomy. We should not
move, manipulate or irrigate the nasogastric tube. We should notify a physician immediately if the tube becomes dislodged or stops functioning properly
Early mobilisation as well as early leg and ankle exercises can prevent DVTs. For esophagectomy patients early mobilisation on the first day can include
Getting them out of bed to a chair
During surgery of esophagectomy a feeding jejunostomy tube is placed and is removed depending on patients progress. It is inserted ..
Through the abdomen and into the jejunum
