Upper GI surgery Flashcards
Where are oesophageal adenocarcinomas found?
Distal oesophagus
What are oesophageal adenocarcinomas related to?
Barett’s oesophagus
Where are oesophageal squamous cell carcinomas found?
Proximal 2/3 of oesophagus
Where are oesophageal squamous cell carcinomas related to?
Smoking and drinking
What investigations are carried out for oesophageal cancer?
Endoscopy
Contrast swallow
What investigations are used to stage oesophageal cancer?
CT
Endoscopic ultrasound
PET
What are the treatment options for metastatic cancer?
Stenting
Palliative radiotherapy and chemo
What are the treatment options for resectable oesophageal cancer?
Oesophagectomy and chemo
Chemo and radiotherapy
What is the mortality rate of an oesophagectomy?
5-10%
What is the 5 year survival of a resectable oesophageal cancer treated with an oesophagectomy and chemo?
30%
What is the 5 year survival of a resectable oesophageal cancer treated with chemo and radiotherapy?
20%
What conduits can be used in an oesophagectomy?
Stomach usually
Colon
What are the 3 approaches to an oesophagectomy?
Ivor Lewis
Trans-hiatal
Left thoraco-abdominal
What investigations can be done for gastric cancer?
Endoscopy
Contrast meal
What investigations are done to stage gastric cancer?
CT chest/abdo
What surgery can be used to treat gastric cancer?
Subtotal gastrectomy
Total gastrectomy and Roux en Y reconstruction
Laproscopic distal gastrectomy
Open gastrectomy
How can gastrooesophageal reflux be treated?
Lifestyle modification
Proton pump inhibitor
Surgery
What investigations are carried out for gastro-oesophageal reflux disease?
Endoscopy
pH studies and manometry
How is gastro-oesophageal reflux disease treated?
Laproscopic hiatus hernia repair
What are bariatric surgeries?
Surgeries to achieve weight loss
What are the types of bariatric surgery?
Restrictive
Malabsorpative
What is the method of action of laparoscopic gastric banding?
Band that can be inflated or deflated placed near top of stomach. Band inflated to narrow passage into stomach
What is the method of action of a laparoscopic gastric bypass?
Small stomach pouch created and attached directly to the second portion of the jejunum, to decrease stomach size and bypass lower stomach, duodenum and jejunum
What is the method of action of a laparoscopic sleeve gastrectomy?
Removal of most of stomach, to leave smaller stomach
What are the complications of bariatric surgery?
Anastamotic leak DVT/PE Infection Malnutrition Nutrient and mineral deficiencies Hair loss Excess skin
