UGI surgery

Question 1

What are the 30 day and 5 year mortalities of open oesophagectomy?

Answer 1

10% & 75% respectively

Question 2

What are the main subtypes of cancer involved at the oesophagus?

Answer 2

Squamous cell carcinoma (typically upper)
Adenocarcinoma (typically lower)

Question 3

What are the risk factors for developing oesophageal cancer?

Answer 3

Poverty
Smoking
Alcohol consumption
Poor nutrition
Achalasia + Plummer vinson syndrome (SCC specifically)
Barrett’s oesophagus (AC specifically)

Question 4

What percentage of patients undergo oesophagectomy for curative reasons?

Answer 4

Typically 1/3 will aim for a curative therapy

Question 5

What are the surgical approaches for oesophagectomy?

Answer 5

Left or right transthoracic
- Right thoracic + laparotomy (classic Ivor-Lewis approach) -> upper 2/3rds

Trans-hiatal
- Involves laparotomy and neck incision
- Generally used in palliative cases, or where thoracotomy is ill-advised