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Alimentary System > Upper GI Surgery > Flashcards

Upper GI Surgery Flashcards

1
Q

What conditions are treated with upper GI surgery?

A

Oesophageal cancer
Gastric cancer
Anti-reflux
Bariatric surgery

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2
Q

Is oesophageal cancer more common in m or F?

A

M

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3
Q

What is the median age for oesophageal cancer?

A

65

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4
Q

In Oesophageal cancer where are adenocarcinomas more likely to occur?

A

Distally

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5
Q

What are the main risk factors for squamous cell carcinoma in the oesophagus?

A

Smoking
Alcohol
Low socio-economic status

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6
Q

What are the symptoms for oesophageal cancer?

A 
Progressive dysphagia 
Anorexia and weight loss 
Odynophagia 
chest pain/heart bur n
Haematemesis
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7
Q

What investigations can diagnose oesophageal cancer?

A

Endoscopy

Contrast swallowing

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8
Q

What investigations need to be done t stage oesophageal cancer?

A

CT of Chest and Abdomen

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9
Q

What classification is used to stage oesophageal cancer?

A

TNM

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10
Q

If metastases are found is any further staging required?

A

No

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11
Q

What is the treatment for metastasised oesophageal cancer?

A

Palliative and supportive therapy

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12
Q

What treatment can be given to relieve symptoms present in oesophageal cancer?

A

Stenting

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13
Q

When is a patient suitable for resection in oesophageal cancer?

A

If no metastases are found and the cancer is primary

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14
Q

What is the treatment for primary oesophageal cancer?

A

Oesophagectomy and chemo

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15
Q

What is an oesophagectomy?

A

Removal of part of the oesophagus

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16
Q

What is inserted after a patient undergoes a oesophagectomy?

A

feeding tube

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17
Q

Anatomically where does an oesophacetomy require access to?

A

Above and below the diaphragm

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18
Q

Is gastric cancer more common in M or F?

A

M

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19
Q

Which bacteria is gastric cancer often associated with?

A

H.pylori

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20
Q

What is the 5yr survival rate of gastric cancer?

A

15-20%

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21
Q

What are the symptoms of gastric cancer?

A 
Non-specific often 
Dyspepsia 
Dysphagia 
Evidence of GI blood loss
Weight loss 
Vomiting 
Upper abdominal mass on examination
22
Q

What investigations are used to diagnose gastric cancer?

A

Endoscopy

Contrast meal

23
Q

What investigations are used to stage gastric cancer?

A

CT chest and abdo

24
Q

What treatment is given before gastric cancer surgery is attempted/

A

Chemotherapy

25
Q

Why is chemotherapy given before gastric cancer surgery?

A

To shrink the tumour and catch any micrometastases

26
Q

What is a subtotal gastrectomy?

A

Removal of part of the stomach

27
Q

What is a total gastrectomy?

A

Removal of the entire stomach

28
Q

What are the two methods for gastrectomy surgery?

A

Laparoscopically

Or open surgery

29
Q

Describe the scar in gastric surgery?

A

Downwards V

30
Q

Why is the scar V shaped with gastric surgery?

A

To stop and overload of pressure of the abdomen wall

31
Q

What is GORD?

A

Gastro-oesophageal Reflux Disease

32
Q

What are the symptoms of GORD?

A

Heartburn
Water brash
Cough

33
Q

What are the risk factors for GORD?

A

Obesity
Smoking
Alcohol

34
Q

Describe oesophageal pH studies as an investigation

A

pH of the stomach is recorded
Along with the patient keeping a diary of their daily symptoms
Assessing to see if there is any correlation between the two

35
Q

What are the classifications of obesity?

A

Overweight
Obesity I
Obesity II
Obesity III

36
Q

What is the BMI of someone overweight?

A

25.0-29.9

37
Q

What is the BMI of someone with Obesity I?

A

30.0-34.9

38
Q

What is the BMI of someone with Obesity II?

A

35.0-39.9

39
Q

What is the BMI of someone with Obesity III?

A

> 40.0

40
Q

Give examples of conditions that obesity is a risk factor for?

A 
Pulmonary disease 
Hypertension 
Cancer 
Pancreatitis 
Gout 
Osteoarthritis 
Fatty liver disease 
CHD 
Stroke 
Cataracts
41
Q

What is restrictive bariatric surgery?

A

When the size of the stomach is decreased

42
Q

What is malabsorptive bariatric surgery?

A

When segments of the bowel are bypassed

43
Q

What is combination bariatric surgery?

A

A mixture of restrictive and malabsorptive bariatric surgery

44
Q

What needs to be taken into consideration with bariatric surgery?

A 
Patients choice 
Safety
Surgeons choice 
Personal 
Patients BMI and co-morbidities
45
Q

What are the Pros of restrictive bariatric surgery?

A

Relatively minor surgery
Reversible and adjustable
Low operative complication rate
Low mortaility

46
Q

What are the cons of restrictive bariatric surgery?

A

Required an implanted device
Easier to cheat
Risk of prolapse of slippage of the band

47
Q

What are the pros of malabsorptive bariatric surgery?

A

Quick and dramatic weight loss
Pedigree
Dumping syndrome

48
Q

What are the cons of malabsorptive bariatric surgery?

A

More invasive
Require lifelong supplements
More complex if require revision
Slight mortality rate

49
Q

What are the pros of combination bariatric surgery?

A

Good medium of surgery
No dumping syndrome
No small bowel manipulation
No foreigns body is implanted

50
Q

What are the cons of combination bariatric surgery?

A

More invasive
Long staple line
Short pedigree
Small mortality rate

51
Q

What are the complications of any bariatric surgery?

A 
Anastomotic leak 
DVT/PE 
Infection 
Malnutrition 
Vitamin and mineral deficiencies 
Hair loss 
Excess skin

Alimentary System (29 decks)

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