upper GI surgery

Question 1

What happens in Barret’s oesophagus

Answer 1

Squamos metaplasia to columnar epithelia - specifically glandular epithelium

Question 2

What are the presenting symptoms of oesophageal cancer

Answer 2

frequent and persistent hiccups
Heartburn
Progressive dysphagia
pain between shoulder blades
Weight loss

Question 3

What are the treatment options for Oesophageal cancer in metastatic patients - unfit for surgery in oesophageal cancer

Answer 3

Stenting to relieve the dysphagia

Palliative radiotherapy
Palliative chemotherapy

Question 4

What is the treatment for oesophageal cancer in well patients

Answer 4

Oesophagectomy
chemotherapy
Radiotherapy

Question 5

What surgery is used for gastric cancer

Answer 5

Gastrectomy

Bypass to stop dysphagia

Jejunostomy - used to bypass stomach

Question 6

How does Hiatus hernia make GORD worse

Answer 6

Reduces the angle of the fundus of the stomach which leads to more reflux

Question 7

What is the treatment for hiatus hernia

Answer 7

Laparoscopic hiatus hernia repair and fundoplication

Question 8

What are the side effects of laparoscopic hiatus hernia repair and fundoplication

Answer 8

Dysphagia
Gas bloating
Diarrhoea and increased flatulence

Question 9

When can bariatric surgery be given

Answer 9

30-35 bmi as conventional treatmentt

> 35 bmi for obesity surgery