Upper Gastrointestinal Surgery Flashcards
What are some risk factors of oesophageal cancer?
Smoking, overweight, alcohol
Rates rising in men
Describe adenocarcinoma of oesophagus
Found in distal oesophagus
Can be due to obesity and gastro-oesophageal reflux
Describe squamous cell carcinoma of the oesophagus
Proximal and middle third of the oesophagus
Smoking and alcohol are risk factors
What are some warning signs of oesophageal cancer?
Frequent and persistent hiccups
Heartburn
Dysphagia
Burping, belching and coughing
Weight loss
What investigations are used for oesophageal cancer?
Endoscopy and contrast swallow
What is used for staging of oesophageal cancer?
CT chest/ abdomen
What happens if patient is metastatic or unfit with oesophageal cancer?
No further staging is required
Palliative and supportive therapy
What staging is used is patient is fit/ oesophageal cancer is resectable?
EUS - T/N staging
PET CT - M staging
What are some treatment options for metastatic/ unfit patients with oesophageal cancer?
Stenting
Palliative radiotherapy
Palliative chemotherapy
What are the treatment options for respectable/ fit patient with oesophageal cancer?
Oesophagectomy and chemotherapy (neoadjuvant)
If concerns of metastasis or fitness then chemo/RT
What are the 3 approaches for an oesophagectomy and which is gold standard?
Ivor Lewis - gold standard
Trans-hiatal
Left Thoraco-abdominal
What is used as a conduit for an oesophagectomy?
Stomach and colon
What are the modifiable risk factors for gastric cancer?
H. pylori
Alcohol
Smoking
Excessive consumption of salted fish, pickled veg and cured meats
What are the alarm symptoms of gastric cancer?
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses or haematemesis
Swallowing difficulty
What investigations are used for gastric cancer?
Endoscopy
Contrast meal
