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GI PATHOLOGY > Upper GI Surgery > Flashcards

Upper GI Surgery Flashcards

1
Q

What is the average age of oesophageal cancer diagnosis?

A

Slightly more male

65 y/o

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2
Q

5 year survival rate of oesophageal cancer?

A

10%

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3
Q

What type of cancer occurs in the proximal and middle third oesophagus?

A

Squamous cell carcinoma

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4
Q

What type of cancer occurs in the distal third oesophagus?

A

Adenocarcinomas

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5
Q

What are the largest risk factors for adenocarcinoma of the oesophagus?

A

Obesity

GORD

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6
Q

What are the largest risk factors for squamous cell carcinoma of the oesophagus?

A

Smoking
Alcohol
Low socio-economic status

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7
Q

How does oesophageal cancer present in patients?

A 
Progressive dysphasia
Anorexia and weight loss
Odynophagia 
Chest pain
Haematemesis
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8
Q

What is odynophagia?

A

Pain when swallowing

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9
Q

How is oesophageal cancer investigated?

A

Endoscopy
Contrast swallow
CT chest/abdo (TNM)

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10
Q

How is oesophageal cancer staged?

A

CT chest abdomen

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11
Q

What treatment is indicated in a patient with metastatic oesophageal cancer?

A

Palliative and supportive care

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12
Q

How is resectable oesophageal cancer staged?

A

T/N - EUS

M - PET CT

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13
Q

How is oesophageal cancer treated in a patient unfit for surgery?

A

Stenting

Palliative radio/chemo

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14
Q

When is chemo/radiotherapy alone indicated in oesophageal cancer patients?

A

Concerns about resection or fitness with NO metastatic disease

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15
Q

What is the main treatment plan in a resectable + fit oesophageal cancer patient?

A

Oesophagectomy

+ chemotherapy

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16
Q

How is an oesophagectomy performed?

A

Large part of oesophagus + tumour removed

Conduit connected to oesophagus

17
Q

What is the morbidity and mortality of oesophagectomy?

A

Morbidity 40%

Mortality 5-10%

18
Q

Male to female ratio of gastric cancer

A

1.8:1

19
Q

5 year survival rate of gastric cancer

A

15-20%

20
Q

How does gastric cancer present?

A 
DYSPEPSIA
Dysphagia 
Evidence of GI blood loss
Weight loss 
Vomiting
Upper GI mass
21
Q

Investigations in suspected gastric cancer?

A

Endoscopy (UGIE)

Contrast meal

22
Q

How is gastric cancer staged?

A

CT chest/abdo

23
Q

Types of gastric cancer surgery?

A

Total gastrectomy + roux en Y

Subtotal gastrectomy

24
Q

What is the presentation of GORD?

A

Heartburn
Water brash
Cough
(often daily)

25
Q

Risk factors for GORD

A

Obesity
Smoking
Alcohol

26
Q

How is GORD managed?

A

Lifestyle changes
PPI
Surgery

27
Q

What structural condition can increase the risk of GORD?

A

Hiatus hernia

28
Q

What investigations are used in suspected GORD?

A

Endoscopy
Oesophageal pH
Manometry

29
Q

Side effects of fundoplication/hiatus hernia repair

A 
Dysphagia
Difficulty to vomit/burp
Gas bloating
Flatulence 
Diarrhoea
30
Q

What are the main types of bariatric surgery?

A

Restrictive
Malabsorptive
Combination

31
Q

Advantages of adjustable gastric band

A

Minor surgery
Reversible/adjustable
Low complication rate
Low mortality

32
Q

Disadvantages of adjustable gastric bands

A

Easy to cheat
Prolapse/slippage
Inplantable device
15% will require followup surgery

33
Q

Adventages of gastric bypass

A

Quick and dramatic weight loss

Pedigree

34
Q

Disadvantages of gastric bypass

A

More invasive surgery
Malabsorptive components require supplementation
More complex
Dumping syndrome

35
Q

Advantages of sleeve gastrectomy

A

No dumping syndrome
No small bowel manipulation
No foregin body

36
Q

Disadvantages of sleeve gastrectomy

A

Staple line
Short pedigree
More invasive surgery

37
Q

Complications of bariatric surgery

A 
Anastomotic leak
DVT/PE
Infections
Malnutrition (vit/macro)
Hair loss
Excess skin

GI PATHOLOGY (20 decks)

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